外伤性脑损伤脑桥快速波谱成像研究  

Fast Spectroscopic Imaging Study of Pons in Traumatic Brain Injury

作　　者：杨昂[1] 肖学红[1] 王志龙[1] 黄晓星[1] 

机构地区：[1]广东省中山市人民医院MR室,528403

出　　处：《临床放射学杂志》2015年第2期186-189,共4页Journal of Clinical Radiology

基　　金：广东省医学科研基金资助项目(编号:A2012817);中山市科技计划项目(编号:20122A081)

摘　　要：目的探讨颅脑外伤(TBI)所致脑桥代谢物变化规律及其与预后的关系。方法对34例TBI患者行快速波谱成像(TSI),获得NAA/Cr、Cho/Cr、Cho/NAA值,并与16例正常志愿者(对照组)进行对比。将TBI组根据格拉斯哥预后评分分为预后良好、中等、差3组,比较不同组间代谢物水平差别。结果 TBI组34例脑桥NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.51±0.73、2.56±0.67、1.05±0.29;对照组16例NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.70±0.37、1.92±0.09、0.72±0.08。两组间NAA/Cr均值差异无统计学意义(P=0.235),两组间Cho/Cr、Cho/NAA均值差异有显著统计学意义(P值均=0.000)。NAA/Cr在预后差组(2.15±0.56)与预后中等组(2.73±0.58)之间、预后差与预后良好组(2.98±0.90)间差异有统计学意义(P值分别为0.036、0.007)。Cho/Cr 3组之间差异无统计学意义。Cho/NAA在预后差组(1.22±0.31)与预后良好组(0.80±0.15)之间差异有统计学意义(P=0.001)。结论 TSI适合TBI脑桥MRS检测,TBI患者脑桥Cho/Cr和Cho/NAA较正常人升高,而NAA/Cr和Cho/NAA比值对TBI预后判断较有意义。Objective To investigate the metabolic changes in pons in patients with traumatic brain injury （TBI） and to assess the value of these changes in predicting outcome. Methods A total of 34 TBI patients （ study group） were in- cluded in this study. By using turbo magnetic resonance spectroscopy imaging technique, the spectroscopic imaging of pons was performed, and the values of N-acetyl aspartate （ NAA）/total creatine （Cr） , choline-containing compounds （ Cho）/Cr and Cho/NAA were determined. Sixteen healthy subjects of the same age group were selected as the control group ; the val- ues of NAA/Cr, Cho/Cr and Cho/NAA were also measured. The results were compared between the two groups. According to Glasgow outcome scale, the TBI patients were divided into good, medium and poor three groups, and the differences in metabolite levels among the three groups were evaluated. Results The NAA/Cr, Cho/Cr and Cho/NAA values of pons of the study group were 2.51 ±0.73, 2.56 ± 0.67 and 1.05±0.29 respectively ; and those of the control group were 2.70 ± 0.37, 1.92 ±0. 09 and 0.72±0.08 respectively. The difference in NAA/Cr value between the two groups was not sig- nificant （ P = 0. 235 ） , while statistically significant differences in Cho/Cr and Cho/NAA value existed between the two groups （P = 0.000）. Statistically significant difference in NAA/Cr value existed between poor outcome group （2.15±0. 56） and medium outcome group （2.73 ± 0.58） （P = 0. 036） , as well as between poor outcome group and good outcome group （2.98±0.90） （P = 0. 007 ）. The difference in Cho/Cr value was not statistically significant among the three groups. The difference in Cho/NAA value between the poor outcome group （ 1.22 ±0.31 ） and good outcome group （0.80 ±0.15 ） was statistically significant （P = 0. 001 ）. Conclusion Turbo magnetic resonance spectroscopy imaging is a suitable technique for the examination of pons in traumatic brain injury patients. The Cho/Cr and Cho/NAA levels o

关 键 词：颅脑外伤 快速磁共振波谱成像 脑桥 

分 类 号：R651.15[医药卫生—外科学] R445.2[医药卫生—临床医学]