DTI和MRS在AIDS相关脑内结核中的临床应用研究  

Clinical application of DTI and MRS in the diagnosis of AIDS-related cerebral tuberculosis

作　　者：褚相乐 马景旭[1] 王红[1] 王云玲[1] 邓佳敏[1] 赵丽萍[1] 

机构地区：[1]新疆医科大学第二附属医院影像中心,新疆乌鲁木齐830063

出　　处：《实用放射学杂志》2016年第4期502-505,517,共5页Journal of Practical Radiology

基　　金：乌鲁木齐市科学技术计划项目（Y131310011）;新疆维吾尔自治区自然科学基金项目（2014211C087）.

摘　　要：目的 探讨扩散张量成像（DTI）和磁共振波谱成像（MRS）定量指标对获得性免疫缺陷综合征（AIDS）相关机会性感染脑内结核的诊断价值。方法 收集17例AIDS合并颅内结核患者及16例正常志愿者，行常规MRI、DTI及多体素MRS扫描，观察病灶形态学表现，测量病例组病灶实质区、水肿区、正常区及对照组相应正常区ADC、FA、rADC、rFA、NAA/Cho、NAA/Cr及Cho/Cr定量指标，并分析其差异性。结果 AIDS相关脑内结核实质区、水肿区及正常区各指标经方差分析均有统计学意义，两两比较，除水肿区与正常区NAA/Cr外，其余均有统计学差异（P〈0.05），实质区ADC值、FA值、rADC值、rFA值，NAA/Cho、NAA/Cr均低于水肿区，Cho/Cr高于水肿区和正常区。受试者工作特征曲线（ROC）分析rFA值用于区分实质区及水肿区的效能最高（P〈0.05）。2组间正常区比较除Cho/Cr外，各指标均有统计学意义（P〈0.05）。结论 DTI可以反映AIDS脑内结核所引起的脑结构微细改变，MRS能反映脑内结核的早期病理代谢特点。Objective To investigate the clinical diagnostic values of quantitative DTI and MRS in AIDS-related cerebral tuberculosis. Methods 17 cases confirmed with AIDS and brain tuberculosis, 16 volunteers were recruited to perform routine MRI,DTI and MRS sequences. Morphological characteristics of lesions were observed. ADC, FA, rADC, rFA, NAA/Cho, NAA/Cr and Cho/Cr of the lesions solid areas,edematous areas,normal areas and contralateral corresponding normal areas were measured and their variances in different areas were analyzed. Results Significant differences of the values were observed among the three regions of AIDS-related brain tuberculosis, the results of multiple comparisons between the three areas had statistical significances （P〈0.05） excepted NAA/Cr between edematous and contralateral areas. ADC, FA, rADC, rFA, NAA/Cho, NAA/Cr on solid areas were lower than that on edematous areas,Cho/Cr on solid areas was higher than that on other two areas. The diagnostic efficiency of rFA value to distinguish solid and edematous areas was the highest by ROC analysis（P〈0.05）. The normal areas of the two groups had statistical significanees（ P〈0.05） excepted Cho/Cr. Conclusion DTI is valuable to display the lesions micro-structure changes and MRS can reflect the early pathology metabolites changes of AIDS-related tuberculosis.

关 键 词：获得性免疫缺陷综合征 结核 脑 扩散张量成像 磁共振波谱成像 

分 类 号：R512.91[医药卫生—内科学] R529.3[医药卫生—临床医学]