脑白质小血管缺血性病变的MRS、DTI研究  

MRS and DTI study of cerebral white matter in small vessel ischemic disease

作　　者：刘晋[1,2,3] 张鲁临 张小鹏[3] 申洪明[4] 

机构地区：[1]山东省肿瘤医院放射科,山东济南250117 [2]济南大学山东省医学科学院医学与生命科学学院 [3]山东省警官总医院 [4]山东省医学科学院

出　　处：《社区医学杂志》2014年第21期1-4,共4页Journal Of Community Medicine

摘　　要：目的应用磁共振波谱(magnetic resonance spectroscopy,MRS)与磁共振张量成像(diffusion tensor imaging,DTI),分析脑白质小血管缺血性病变的微观改变。方法选取2011年12月—2013年6月发生在半卵圆中心、放射冠区的脑白质小血管缺血性病变的患者作为研究对象,其中急性腔隙性梗死组(腔梗组)病灶12例,脑白质疏松组(疏松组)病灶13例,并设置15例正常志愿者作为对照组,行半卵圆中心、放射冠区T1加权像(T1weighted imaging,T1WI)、T2加权像(T2weighted imaging,T2WI)、T2液体衰减反转恢复(fluid attenuated inversion recovery,FLAIR)、扩散加权成像(diffusion weighted imaging,DWI)、MRS、DTI扫描。测量NAA、Cho、Cr值,测量平均弥散系数(mean diffusivity,MD)、部分各向异性分数(fractional anisotropy,FA)。比较3组NAA、Cho、Cr、MD、FA值,计量资料采用t检验,P<0.05为差异有统计学意义。结果腔梗组、疏松组与对照组比较,NAA值降低[(20.9±4.2)、(19.2±3.7)、(27.1±1.6)],差异有统计学意义(P<0.05)。疏松组与腔梗组及对照组分别比较,Cho降低[(14.2±2.6)、(12.3±2.3)、(15.7±2.1)],差异有统计学意义(P<0.05)。疏松组与腔梗组及对照组比较Cr降低[(10.7±2.3)、(12.6±2.0)、(15.7±2.1)],差异有统计学意义(P<0.05)。腔梗阻、疏松组与对照组比较,FA降低[(0.266±0.744)、(0.250±0.735)、(0.493±0.492)],差异有统计学意义(P<0.05)。3组MD值[(0.494±0.113)、(1.308±0.212)、(0.704±0.429)mm2/s]差异有统计学意义(P<0.05)。结论在脑白质小血管缺血性病变中,NAA、FA值显著降低,共同反映了神经轴突髓鞘结构和功能的损伤、破坏;联合应用MRS、DTI分析评价脑白质小血管缺血性病变,将有助于全面认识其发病机制及病理改变。Objective To study the microscopic changes of cerebral white matter in small vessel ischemic disease with MRS and DTI.Methods Twelve cases of acute lacunar infarction of the white matter and 13 cases of ischemic leukoaraiosis,in which the centrum semiovale and corona radiate area were affected,were selected,and 15 normal volunteers were as control group. Then all cases underwent T1 WI,T2WI,T2 FLAIR,DWI,MRS and DTI scans and were measured for the level of N-acetyl aspartate（NAA）,choline（Cho）,creatine（Cr）,mean diffusivity（MD） and fractional anisotropy（FA）.Analysis of variance was conducted on NAA,Cho,Cr,MD and FA between the three groups.T-test was used for measurement data,and P〈0.05 was considered statistically significant.Results Compared with control group,the level of NAA reduced significantly in lacunar infarction group and leukoaraiosis group（P〈0.05）.Compared with control group,the level of Cho reduced significantly in lacunar infarction group and leukoaraiosis group（P〈0.05）.Compared with control group and lacunar infarction group,the level of Cr increased significantly in leukoaraiosis group（P〈0.05）.Compared with control group,the level of FA reduced significantly in lacunar infarction group and leukoaraiosis group（P〈0.05）.the value of MD showed significant difference between the three groups（P〈0.05）.Conclusion For the microscopic changes of cerebral white matter in small vessel ischemic disease,the level of NAA and FA is significantly reduced,cooperatively reflecting the destruction and damage of the structure and function of axonal myelin sheath.Combined application of MRS and DTI will be helpful to the comprehensive understanding of its pathogenesis and pathological changes.

关 键 词：脑小血管疾病 脑白质疏松 腔隙性脑梗死 磁共振波谱 弥散加权成像 

分 类 号：R743[医药卫生—神经病学与精神病学]