脑梗死后锥体束 Wallerian 变性的氢质子磁共振波谱分析  

Hydrogen proton magnetic resonance spectroscopy study on early Wallerian degeneration of the pyramidal tract after cerebral infarction

作　　者：严肃[1] 张联合[2] 葛宇曦[3] 吴立伟[1] 单海荣[1] 沈文东[1] 

机构地区：[1]宜兴市人民医院放射科,江苏宜兴214200 [2]武警浙江总队杭州医院放射科 [3]无锡市第四人民医院放射科

出　　处：《实用放射学杂志》2015年第5期722-725,共4页Journal of Practical Radiology

基　　金：江苏大学2012年度医学临床科技发展基金项目（JLY20120066）.

摘　　要：目的：探讨氢质子磁共振波谱（1 H-MRS）技术检测脑梗死后锥体束 Wallerian 变性的可行性。方法利用1 H-MRS 技术检测15例单侧大脑中动脉供血区脑梗死患者和15例年龄匹配的健康志愿者双侧大脑脚的多个代谢指标,包括 N-乙酰天门冬氨酸（NAA）、胆碱复合物（Cho）、肌酸（Cr）,并计算 NAA/Cr、Cho/Cr 值。比较该值在脑梗死组及对照组间的差异,并进行 ROC 曲线分析。结果脑梗死患者同侧大脑脚 NAA/Cr 值明显低于对侧,二者存在统计学差异（P〈0.05）。与对照组相比,脑梗死患者同侧大脑脚 NAA/Cr 值明显减低（P〈0.05）；ROC 曲线下面积为0.947,截断点为1.63。脑梗死患者对侧大脑脚 NAA/Cr 值与对照组比较无统计学差异（P〉0.05）,同侧、对侧大脑脚 Cho/Cr 值与对照组比较无统计学差异（P〉0.05）。结论1 H-MRS 可以在脑梗死检测到锥体束Wallerian 变性。Objective To investigate the feasibility of hydrogen proton magnetic resonance spectroscopy （IH-MRS） for detection of Wallerian degeneration of the pyramidal tract after cerebral infarction. Methods Multiple metabolic indices including NAA,Cho, Cr of the bilateral cerebral peduncle were detected by using ~ H-MRS in 15 patients with unilateral middle cerebral artery infarction and 15 age-matched healthy volunteers, NAA/Cr,Cho/Cr were also calculated. Comparing the difference between cerebral infarction group and the control group ,the ROC curve was analyzed. Results The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients were significantly lower than that of the contralateral,and there were significant differences between the two groups（P〈0.05 ）. The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients decreased （P〈0.05）, as compared with that of the control group. The area under the ROC curve was 0. 947,the truncation point was 1.63. The NAA/Cr values of the contralateral cerebral peduncle of cerebral infarction patients had no significant differences compared with the control group （P〉0.05） ,the Cho/Cr values of the ipsilateral and the contralateral cerebral peduncle had no significant difference compared with the control group （P〉0.05）. Conclusion l H-MRS can detect Wallerian degeneration of the pyramidal tract after cerebral infarction.

关 键 词：氢质子磁共振波谱 Wallerian 变性 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]