磁共振波谱和扩散张量成像在颈内动脉狭窄性短暂性脑缺血发作中的应用研究  

Imaging value of magnetic resonance spectroscopy (MRS) and magnetic resonance diffusion tensor imaging (DTI) in diagnosis for unilateral internal carotid artery (ICA) narrow transient ischemic attack (TIA)

作　　者：王洁[1] 董海波[1] 陈峰[2] WANG Jie;DONG Haibo;CHEN Feng(Radiology Department,Ningbo City Medical Treatment Center Lihuili Hospital,Ningbo 315040,China;Department of Neurology,Ningbo City Medical Treatment Center Lihuili Hospital,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院放射科,浙江宁波315040 [2]宁波市医疗中心李惠利医院神经内科,浙江宁波315040

出　　处：《中国现代医生》2018年第17期95-98,共4页China Modern Doctor

基　　金：浙江省宁波市卫生和计划生育委员会医学科技计划项目(2016A11)

摘　　要：目的研究磁共振波谱成像(MRS)及磁共振扩散张量成像(DTI)对单侧颈内动脉(ICA)狭窄性短暂性脑缺血发作(TIA)的影像学评估价值。方法选取35例经数字减影血管造影(DSA)证实为单侧ICA重度狭窄的TIA患者,对其进行常规头颅MR、MRS及DTI检查。比较狭窄侧及对侧半卵圆中心区脑内代谢物N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)和乳酸(Lac)的浓度值。比较狭窄侧及对侧额叶、顶叶、枕叶、颞叶、内囊前肢、内囊后肢FA值的差异。结果 35例TIA患者半卵圆中心区层面双侧脑代谢存在差异,ICA狭窄侧NAA降低、Cho升高,与对侧相应区域比较,差异有统计学意义(P<0.05)。两侧Cr变化不明显,差异无统计学意义(P>0.05)。ICA狭窄侧额叶、顶叶、内囊后肢FA值较对侧降低,差异有统计学意义(P<0.05)。而枕叶、颞叶、内囊前肢FA值变化不明显,差异无统计学意义(P>0.05)。结论联合应用MRS、DTI技术可提示TIA患者脑组织生物代谢的改变及脑白质缺血受损情况,为临床及时采取有效的治疗措施提供依据。Objective To explore the imaging value of Magnetic Resonance Spectroscopy(MRS)and Magnetic Resonance Diffusion Tensor Imaging(DTI)in diagnosis for unilateral internal carotid artery(ICA)narrow transient ischemic attack(TIA).Methods 35 patients who had been diagnosed as TIA of severe unilateral ICA stenosis by digital subtraction angiography(DSA)were selected and detected by routine MR,MRS and DTI examination of head.We compared the concentrations of intracerebral metabolites including N-acetyl aspartic acid(NAA),choline(Cho),creatine(Cr)and lactic acid(Lac)on the stenotic side and the contralateral centrum ovale,as well as the value of FA of frontal lobe,parietal lobe,occipital lobe,temporal lobe,inner capsule forelimb and inner capsule posterior limb on stenotic side and contralateral side.The concentration on narrow side of NAA was lower and that of Cho was higher compared to the contralateral side and these differences were significant.Results There was significant difference in metabolism between the two sides of centrum ovale of the 35 cases with TIA(P<0.05).There was no significant difference in the change of Cr concentration(P>0.05).The FA values of frontal lobe,parietal lobe and inner capsule posterior limb on stenotic side were relatively lower than those on contralateral side and the differences were significant(P<0.05).However,there was no significant difference in the FA values of occipital lobe,temporal lobe and inner capsule forelimb between the two sides(P>0.05).Conclusion Combined application of MRS and DTI technology can prompt changes in brain tissue metabolism and white matter ischemia in TIA patients,which provides evidence for effective clinical treatment.

关 键 词：磁共振波谱成像 扩散张量成像 颈内动脉狭窄 短暂性脑缺血发作 

分 类 号：R743.3[医药卫生—神经病学与精神病学]