HIV相关无症状性神经认知损害1H-MRS初探  

A preliminary study about 1H-MRS in HIV patients associated with asymptomatic neurocognitive impairment

作　　者：李玉欣 喻奇志 周晓玲 江登科 熊赞 LI Yu-xin YU Qi-zhi ZHOU Xiao-ling et al(Department of Radiology, the First Hospital of Changsha,Changsha 410008,China)

机构地区：[1]长沙市第一医院放射科,长沙410008 [2]湖南中医药大学第二附属医院放射科,长沙410007

出　　处：《放射学实践》2016年第11期1030-1033,共4页Radiologic Practice

基　　金：湖南省卫生厅科研计划课题项目(B2014-146)

摘　　要：目的:探讨多体素氢质子磁共振波谱成像(1 H-MRS)在HIV感染相关性无症状神经认知损害患者早期诊断中的临床价值。方法:采用1 H-MRS对已证实HIV阳性无症状性神经认知障碍的28例患者(CD4计数≤200cell/uL为A组16例、CD4计数>200cell/uL为B组12例)以及30例正常志愿者(C组)进行扫描,分别测量双侧额叶及基底节兴趣区NAA、Cho、Cr值,比较各组间NAA/Cr,Cho/Cr值。结果:A组额叶白质、基底节兴趣区NAA/Cr值分别为0.9±0.28、1.06±0.28,B组额叶白质及基底节兴趣区NAA/Cr值分别为1.28±0.14、1.49±0.25,C组额叶白质及基底节兴趣区NAA/Cr值分别为1.46±0.35、1.54±0.31。A组额叶白质及基底节区NAA/Cr值低于B组及C组,差异均有统计学意义(P<0.05)。B组额叶白质NAA/Cr值显著低于C组(P=0.049)。A、B组额叶白质及基底节区Cho/Cr值与C组差异均无统计学意义(P>0.05)。结论:MRS能反映HIV相关性神经认知紊乱患者无症状期期脑内NAA、Cho、Cr等产物代谢异常,且与CD4细胞计数有一定关系。Objective：The purpose of this study was to explore the imaging significance of 1 H-MRS （magnetic reso nance spectroscopy） using multi-voxel PRESS sequence in the HIV patients with asymptomatic neurocognitive impairment on their early diagnosis. Methods： Multi-voxel 1 H-MRS were scanned in 28 HIV-positive patients with cognition disorder which included 16 CD 4＋T Lymphocyte counts ≤ 200 cells μL （group A）, and 12 CD 4＋ T Lymphocyte counts〉 200cells/μL （group B）,and in 30 HIV-negative healthy volunteers （group C）. Brain metabolites,including N-acetylaspartate （NAA）,choline-containing compounds （Cho） and creatine （Cr）,were measured at the frontal white matter and basal ganglia. Concentrations of metabolites NAA, Cho,and Cr （NAA/Cr,Cho/Cr） were calculated too. Results： Ratios of NAA/ Cr in the frontal white matter and basal ganglia were significantly decreased in group A （0.9 ± 0.28,1.06 ± 0.28） compared with those in group B （1.28±0.14,1.49±0.25） and group C （1.46±0.35,1.54±0.31） with P〈0.05. Ratio of NAA/Cr in the frontal white matter was significantly decreased in group B compared with that in group C with P= 0. 049 〈0.05. However, compared to group C, ratio of Cho/Cr at the frontal white matter and ganglia had no significant difference. Conclusion：The results of this study indicate that MRS can detect the abnormal metabolism in the brain in HIV patients with asymptomatic neurocognitive impairment. The cerebral metabolite levels might be correlated with decreased CD4 ＋ T Lymphocyte counts.

关 键 词：获得性免疫缺陷综合征 艾滋病痴呆复合征 磁共振成像 磁共振波谱成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R512.91[医药卫生—诊断学]