磁共振波谱成像对椎基底动脉供血不足的应用价值  

Application value of magnetic resonance spectroscopy in vertebrobasilar blood supply insufficiency

作　　者：贺春妮[1] 李军[1] 

机构地区：[1]滨州医学院烟台附属医院放射科,山东烟台264100

出　　处：《中国临床医学影像杂志》2015年第5期359-361,364,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:应用磁共振波谱技术(MRS)探讨椎基底动脉供血不足(VBI)患者的枕叶及小脑代谢物变化。方法:选取9例经临床和MRA诊断为VBI患者和7名年龄相匹配的健康志愿者(对照组),采用化学位移成像采集枕叶及小脑的MRS数据,测量VBI患者及正常对照组的代谢物比值NAA/Cr、NAA/Cr2、Cho/Cr、Cho/Cr2、NAA/Cho,采用Mann-Whitney U检验比较两组间MRS代谢参数之间的差异;并统计两组间Lac峰出现的例数,应用Fisher确切概率法比较有无差异。结果 :VBI患者组枕叶的NAA/Cr、NAA/Cr2、Cho/Cr、Cho/Cr2、NAA/Cho与对照组差异无统计学意义(均P>0.05);VBI患者组小脑的NAA/Cr低于对照组(0.83±0.15比0.98±0.14,P=0.043),NAA/Cr2、Cho/Cr、Cho/Cr2、NAA/Cho与对照组差异无统计学意义(均P>0.05);9例VBI患者中4例在小脑可探测到Lac峰,1例在枕叶可探测到Lac峰,对照组均未探测到Lac峰,差别具有统计学意义(P=0.034)。结论:应用MRS技术可敏感的探测VBI患者脑组织代谢物的变化,有助于从生化角度评价VBI导致的脑损害。Objective： To explore changes of metabolite levels in the occipital lobe and cerebellum for patients with vertebral-basilar insufficiency（VBI） by magnetic resonance spectroscopy（MRS）. Methods： The study group consisted of nine patients diagnosed with VBI by clinical and MRA methods. Seven age-matched healthy subjects were recruited in the control group. MRS by multi-voxel chemical shift imaging was performed. The metabolite ratios of occipital lobe and cerebellum involving NAA/Cr, NAA/Cr2, Cho/Cr, Cho/Cr2 and NAA/Cho were estimated. The Mann-Whitney U test was performed to compare the differences between the two groups. The appearance of Lac peak was noted between two groups and Fisher＇s exact test was performed to compare the differences. Results： There was no statistical difference for the ratios of NAA/Cr2, Cho/Cr2,NAA/Cho in occipital lobe（P〉0.05）. The ratio of NAA/Cr in cerebellum with VBI was found decreased compared to normal control subjects（0.83±0.15 vs 0.98±0.14, P=0.043）. There was no statistical difference for the ratios of NAA/Cr2, Cho/Cr2, NAA/Cho in cerebellum（P〉0.05）. Lac peaks were detected in the cerebellum in four VBI cases and in the occipital lobe in one VBI case. and no Lac peak was detected in the control group with statisticaldifference（P=0.034）. Conclusion： MRS is a useful tool for evaluation of major changes of metabolite levels in brain and may contribute to evaluate the damage caused by VBI biochemically.

关 键 词：椎底动脉供血不足 磁共振波谱学 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]