核磁共振波谱成像在急性CO中毒迟发性脑病诊断中的应用价值  

Value of nuclear magnetic resonance spectroscopic imaging in diagnosis of delayed encephalopathy after acute carbon monoxide poisoning

作　　者：关里[1] 赵金垣[1] 毛丽君[1] 张雁林[1] 

机构地区：[1]北京大学第三医院职业病研究中心,北京100191

出　　处：《中国工业医学杂志》2015年第3期187-189,共3页Chinese Journal of Industrial Medicine

基　　金：国家自然科学基金青年基金(HO-1/CO系统在急性一氧化碳中毒迟发性脑病中的致病作用研究;编号:81101024)

摘　　要：核磁共振成像(magnetic resonance imaging,MRI)目前已成为临床常规采用的神经影像学检查方法,而核磁共振波谱分析(magnetic resonance spectroscopy,MRS)技术作为一种在体、无创检查方法,又对MRI进行了补充和完善,通过显示脑组织代谢状态,成为神经影像学检查的新工具。应用于临床的MRS主要有两种,即1H-MRS和31P-MRS,由于氢质子有高天然丰度特性,所以1H-MRS分析技术的灵敏度更高,目前在神经系统检查的应用也更广泛;它可以灵敏地反映脑组织常见代谢产物N-乙酰-L-天门冬氨酸、肌酸、乳酸和脂类等代谢水平及变化,甚至早于脑组织形态学改变,因此可为神经系统疾病的临床早期预警和医学干预提供重要线索。急性一氧化碳中毒后迟发性脑病是急性CO中毒最严重的并发症之一,利用1H-MRS跟踪一氧化碳中毒迟发性脑病患者脑组织常见代谢产物浓度变化,对于判断CO中毒患者预后和早期进行医学干预具有重要意义。Magnetic resonance imaging（ MRI） has become a routine clinical examination in neuroimaging. As a new non-invasive examination technique,magnetic resonance spectroscopy（ MRS） is a supplement and perfection of MRI,which even could check themetabolism in brain. There are two kinds of MRS for clinical application,namely1H-MRS and31P-MRS,but since the higher natural abundance feature of proton,1H-MRS＇s has much better sensitivity and wider application especially in examination of central nervous system disease. It can sensitively measure the common metabolites and their changes in brain,such as N-acetyl aspartate,creatine,lactate,lipids,etc. even earlier than the morphological change. Delayed encephalopathy after acute carbon monoxide poisoning is one of the most serious complication of acute CO poisoning,1H-MRS can be used to track these changes in brain,which should be very important for judging the prognosis of disease and giving medical intervention for the patients.

关 键 词：一氧化碳中毒迟发性脑病(DEACMP) 核磁共振波谱(MRS) N-乙酰-L-天门冬氨酸(NAA) 肌酸(Cr) 乳酸(Lac) 

分 类 号：R595.1[医药卫生—内科学]