MRS与DWI联合成像在颈髓损伤诊断中的应用价值  

The value of combined MRS and DWI in diagnosis of cervical cord injury

作　　者：郭会利[1] 李培岭[1] 张斌青[1] 张国庆[1] 杨静[1] 叶艳君[1] 李盼盼[1] 

机构地区：[1]河南省洛阳正骨医院河南省骨科医院影像中心,河南洛阳471002

出　　处：《实用放射学杂志》2016年第3期335-338,共4页Journal of Practical Radiology

基　　金：河南省公益科研院所预研项目（082103810904）.

摘　　要：目的探讨MRS与DWI序列在颈髓损伤诊断中的价值。方法对95例颈髓损伤患者的MRI平扫图像进行分析，根据T2WI上脊髓信号有无改变，分为A组——不完全损伤组（T2WI信号无异常）63例和B组——完全损伤组（T2WI高信号）32例，C组——对照组50例，进行MRS及DWI检查，分别测量氮-乙酰天门冬氨酸（NAA）、胆碱复合物（Cho）、肌酸（Cr）、乳酸（Lac）波峰面积及表观扩散系数（ADC）值，并分析NAA／Cho、NAA／Cr、Cho／Cr、Lac／Cho值及ADC值。结果在MRS序列上，B组较A组中NAA／Cho、NAA／Cr显著减低（P〈0．05）；B组与C组比NAA／Cho、NAA／Cr值降低，Lac／Cho值升高（P〈0．05）；A组与C组比仅Lae／Cho值升高（P〈0.05）。在DWI上，A组ADC值为（0.79±0．17）×10^-3mm^2／s，低于C组（0.93±0．15）×10^-3mm^2／s（P=0．026）；B组ADC值为（1．21±0．20）×10^-3mm^2／s，明显高于C组（P=0．017）；A组与B组比较，前者ADC值低于后者，但差异无统计学意义（P=0．143）。结论MRS可以无创定量测定创区颈髓相关代谢介质的变化，从代谢及分子水平反映颈髓损伤的不同程度；DWI对颈髓损伤的早期诊断具有较高的敏感性；DWI及MRS联合成像对临床制订合理的治疗方案及预后评估有重要的意义。Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury. Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed. They were divided into two groups according to the T2 signal of cervical cord, 63 cases in Group A（ incomplete injury group） with no abnormal on T2 , 32 cases in Group B（ complete injury group） with high signal on T2. The other 50 cases with no injury of cervical cord were recruited as control group （Group C）. All the cases were performed with MRS and DWI. The N-acetyl aspartic acid（NAA）, choline compounds（Cho） and creatine（Cr） as well as the peak area of lactic acid （Lac） on MRS,and apparent diffusion coefficient（ADC） on DTI were measured separately. Mean while,NAA/Cho,NAA/Cr, Cho/Cr, Lac/Cho and ADC were analyzed. Results On MRS sequence, the values of NAA/Cho and NAA/Cr were lower in Group B （P〈0.05） when compared with Group A. The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C. However, the value of Lac/Cho in Group B was higher than it in Group C（P〈0.05）. When com- pared Group A with Group C,the value of Lac/Cho only increased in the former. However, on DWI, the value of ADC in Group A was（0.79±0.17）×10^-3 mm^2/s,lower than that of Group C（0. 93±0.15）×10^-3 mm^2/s （P=0. 026） ; the value of ADC in Group B was（1.21±0.20）×10^-3 mm^2/s,significantly higher than that of Group C（P=0. 017）. When compared with Group B, the value of ADC in Group ＆ was a lightly lower （P〈0. 143） with no statistical significance. Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level. DWI has high sensitivity on early diagnosis of cervical cord injury. The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evalua

关 键 词：颈髓损伤 扩散加权成像 磁共振波谱成像 

分 类 号：R744[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]