多体素磁共振波谱在早产儿脑组织代谢产物分析中的应用  

Analysis of metabolite levels in brain of preterm neonates by using multi-voxel magnetic resonance spectroscopy

作　　者：王宏[1] 秦明明[1] 汤文琳 钱伟亮 杨祖铭[3] 颜博秋[4] 许建铭[1] 

机构地区：[1]南京医科大学附属苏州医院(苏州市立医院本部)影像科,苏州215002 [2]西门子医疗系统有限公司,上海201318 [3]南京医科大学附属苏州医院(苏州市立医院本部)新生儿科,苏州215002 [4]南京医科大学附属苏州医院(苏州市立医院本部)儿保科,苏州215002

出　　处：《磁共振成像》2017年第12期891-896,共6页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的通过多体素磁共振波谱(~1H-magnetic resonance spectroscopy,~1 H-MRS)了解围产期缺氧窘迫、感染对早产儿脑内各特定区域脑组织代谢的影响。材料与方法 60例早产儿在36 w<矫正胎龄≤37 w行常规磁共振检查及~1 H-MRS检查,共有48例早产儿被纳入本研究并分为4组:围产期正常组13例、围产期缺氧窘迫组10例、围产期感染组12例、围产期缺氧窘迫伴感染组13例,4组早产儿分别测定基底节及丘脑(basal ganglia and thalami,BGT)、两侧脑室周围白质(white matter,WM)的N-乙酰基天门冬氨酸(N-acetyl aspartate,NAA)/肌酸(creatine,Cr)、胆碱化合物(choline,Cho)/Cr、乳酸(lactate,Lac)/Cr的比值。(1)围产期正常组早产儿在侧脑室前角、后角周围白质区就NAA/Cr、Cho/Cr比值进行配对设计计量资料的t检验,α=0.05作为检验标准;(2)4组间各代谢产物数据先行单因素方差分析,当P<0.05时,再行样本均数两两比较的q检验(SNK法),α=0.05作为检验标准。结果 (1)围产期正常组早产儿侧脑室前角、后角周围白质区的NAA/Cr、Cho/Cr比值差异有统计学意义(P<0.001);(2)在BGT区域,围产期正常组分别与缺氧窘迫组、缺氧窘迫伴感染组比较,缺氧窘迫组与感染组比较,感染组与缺氧窘迫伴感染组比较,NAA/Cr、Cho/Cr、Lac/Cr的差异均有统计学意义(P<0.05)。围产期正常组与感染组、缺氧窘迫组与缺氧窘迫伴感染组比较,NAA/Cr、Cho/Cr、Lac/Cr的差异无统计学意义(P>0.05);(3)在WM区域,围产期正常组分别与缺氧窘迫组、缺氧窘迫伴感染组比较,感染组与缺氧窘迫伴感染组比较,NAA/Cr、Cho/Cr、Lac/Cr的差异有统计学意义(P<0.01)。围产期正常组与感染组比较,缺氧窘迫组与缺氧窘迫伴感染组比较,Cho/Cr的差异有统计学意义(P<0.05)。缺氧窘迫组与感染组比较,NAA/Cr、Lac/Cr的差异有统计学意义(P<0.05)。结论 (1)早产儿脑白质神经纤维髓鞘化存在前后梯度,侧脑室后角周围白质髓�Objective： To investigate the influence for metabolite levels in brain of preterm neonates who suffered perinatal asphyxia or perinatal infection by using multi-voxel magnetic resonance spectroscopy. Materials and methods： A total of 60 preterm neonates at term-equivalent age underwent MRI examination. The MRI examinations including multi-voxel 1H-MRS and other conventional plain sequences were performed using MAGNETOM Skyra （Siemens Healthcare, Erlangen, Germany）, and 48 preterm infants were fnally enrolled in this study and were divided into four groups： Group 1 （n=13, perinatal normal）, Group 2 （n=10, perinatal asphyxia）, Group 3 （n=12, perinatal infection） and Group 4 （n=13, perinatal asphyxia and infection）. NAA/Cr, Cho/Cr, Lac/Cr ratios were collected from voxels located the basal ganglia and thalami （BGT） and periventricular white matter （WM）, and all metabolic data were analyzed by SPSS 21.0 statistical software. Metabolic values were analyzed by t test in Group 1 and were analyzed by one-way ANOVA across 4 groups, if P〈0.05, q test for multiple comparisons were analyzed by SNK method. Results： ① The differences of both NAA/Cr and Cho/Cr between anterior periventricular white matter and posterior periventricular white matter were statistically signifcant in Group 1 （P〈0.001）. ② In BGT region, the differences of all metabolic values including NAA/Cr, Cho/Cr and Lac/Cr were statistically signifcant between Group 1 and Group 2, between Group 1 and Group 4, between Group 2 and Group 3, between Group 3 and Group 4. ③ In region of WM, the differences of all metabolic values including NAA/Cr, Cho/Cr, Lac/Cr were statistically signifcant between Group 1 and Group 2, between Group 1 and Group 4, between Group 3 and Group 4; The difference of Cho/Cr was statistically signifcant between Group 1 and Group 3, between Group 2 and Group 4; The differences of both NAA/Cr and Lac/Cr were statistically signifcant between Group 2 and Group 3. Conclusions： ① The antero-po

关 键 词：磁共振波谱 早产儿 围产期缺氧窘迫 围产期 磁共振成像 脑白质 

分 类 号：R445.2[医药卫生—影像医学与核医学] R729[医药卫生—诊断学]