早期HIV相关神经认知紊乱的磁共振波谱研究  

Magnetic Resonance Spectroscopy Study of Early HIV Related Neurocognitive Disorders

作　　者：钟正 李亚军[1] 

机构地区：[1]中南大学湘雅二医院放射科,湖南长沙410011 [2]长沙市第一医院放射科,湖南长沙410003

出　　处：《中国医学影像学杂志》2017年第9期641-645,共5页Chinese Journal of Medical Imaging

基　　金：湖南省卫生厅科研基金(B2014-146)

摘　　要：目的探讨早期人类免疫缺陷病毒(HIV)相关神经认知紊乱(HAND)的磁共振波谱(MRS)改变以及MRS对早期HAND临床分期的价值。资料与方法采用二维多体素点分辨波谱对26例HAND 0.5期患者(A组)、18例HAND 0期患者(B组)及18例健康对照者(C组)进行扫描。对称测量双侧额叶白质及豆状核N-乙酰天门冬氨酸(NAA)、NAA/肌酸(Cr)、胆碱(Cho)值,比较组间各指标的差异。结果与C组相比,B组左侧额叶白质、左侧豆状核NAA值降低,差异有统计学意义(P<0.05);A组双额叶白质和双侧豆状核NAA值以及双额叶白质NAA/Cr均降低,差异有统计学意义(P<0.05)。与B组相比,A组仅右额叶白质区NAA值降低,差异有统计学意义(P<0.05)。与C组和B组比较,A组右侧豆状核Cho值均减低,差异有统计学意义(P<0.05)。结论 0期HAND患者MRS改变为左侧额叶白质及左侧豆状核NAA降低。右侧额叶白质NAA降低对HAND 0期及0.5期具有一定的参考价值,Cho改变在每个感兴趣区的变化不一致,在早期诊断及分期中的意义有待进一步研究。Purpose To investigate the changes of magnetic resonance spectroscopy（MRS） in early HIV-associated neurocognitive disorders（HAND） and the significance of MRS in early clinical staging of HAND. Materials and Methods Two-dimensional multi voxel point resolved spectroscopy scan were performed on 26 HAND patients of stage 0.5（group A）, 18 HAND patients of stage 0（group B） and 18 healthy controls（group C）. The NAA, NAA/Cr and Cho values of bilateral frontal lobe white matter and lenticular nucleus were measured symmetrically and the differences of each index among the groups were compared and analyzed. Results Compared with group C, NAA of left frontal lobe white matter and left lenticular nucleus decreased in group B, and the difference was statistically significant（P〈0.05）. NAA of bilateral frontal lobe white matter and bilateral lenticular nucleus decreased in group A, along with NAA/Cr of bilateral frontal lobe white matter, and the difference was statistically significant（P〈0.05）. Only the NAA value of the right frontal lobe in group A was decreased when compared with group B, and the difference was statistically significant（P〈0.05）. The Cho value of the right lenticular nucleus in group A was lower than that of both group C and group B, and the difference was statistically significant（P〈0.05）. Conclusion MRS change in HAND patients of stage 0 was characterized by decrease in NAA values of left frontal lobe white matter and left lenticular nucleus. The decrease of NAA in the right frontal lobe white matter has a certain reference value for 0 and 0.5 clinical staging of HAND. The change of Cho in each region of interest is inconsistent and its significance in early diagnosis and staging should be further studied.

关 键 词：HIV 认知障碍 磁共振成像 磁共振波谱学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.04[医药卫生—诊断学]