基于^1H-MRS探究乳腺浸润性导管癌化疗后幸存者记忆功能改变的海马代谢  

Hippocampal Metabolism of Survivors with Memory Function After Chemotherapy with Invasive Ductal Carcinoma of the Breast Based on ^1H-MRS

作　　者：刘同辉 李朋 周琳 陈瑞 冯伟 张华文 LIU Tonghui;LI Peng;ZHOU Lin;CHEN Rui;FENG Wei;ZHANG Huawen(Department of Medical Imaging,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)

机构地区：[1]陕西省核工业二一五医院医学影像科,陕西咸阳712000

出　　处：《中国医学影像学杂志》2020年第5期339-342,共4页Chinese Journal of Medical Imaging

基　　金：陕西省重点研发计划(2019SF-209)。

摘　　要：目的应用氢质子磁共振波谱分析(1H-MRS)研究乳腺癌化疗幸存者海马代谢与记忆功能的关系。资料与方法选择经病理证实并行EC-T化疗的乳腺浸润性导管癌29例,同期选择健康志愿者42例为对照组。所有受试者先行听觉词语测试(AVLT-H)及数字广度测试评分,后行全脑3DT1WI扫描,选取双侧海马为感兴趣区,行单体素1H-MRS扫描,采用MR仪配套工作站进行海马波谱数据测量,对双侧海马波谱数据及量表评分进行分析,并对有差异的结果与化疗后病程进行相关性分析。结果两组受试者AVLT-H及数字广度测试评分差异无统计学意义(P>0.05)。乳腺癌组右侧海马胆碱浓度高于对照组(14.39±3.27比12.38±3.22,t=2.46,P=0.02),左侧海马N-乙酰基天门冬氨酸(NAA)/肌酸值低于对照组(1.23±0.18比1.35±0.24,t=-2.15,P=0.04)。乳腺癌组左侧NAA、肌酸浓度、胆碱浓度、胆碱/肌酸值与对照组比较,差异无统计学意义(P>0.05)。乳腺癌组化疗后的左侧海马NAA/肌酸值、右侧海马胆碱浓度与化疗后病程无明显相关性(r=-0.22、-0.04,P>0.05)。结论接受标准EC-T化疗的乳腺浸润性导管癌幸存者海马代谢仍然存在异常,且这种代谢异常与化疗后病程无明显关系,但记忆功能恢复至正常水平。Purpose To investigate the relationship between hippocampal metabolism and memory function in survivors of breast cancer chemotherapy using hydrogen proton magnetic resonance spectroscopy(1 H-MRS),and to analyzed the relationship between hippocampal metabolic abnormalities and memory function.Materials and Methods Twenty-nine cases of breast invasive ductal carcinoma confirmed by pathology and EC-T chemotherapy were selected,and 42 healthy volunteers were selected as the control group during the same period.All subjects were first scored by the auditory vocabulary test(AVLT-H)and digital breadth test,and then the whole brain 3 DT1 WI scan was selected,the bilateral hippocampus was selected as the area of interest,and the single element 1 H-MRS scan was performed using the MR instrument supporting workstation.Measurement of hippocampal spectrum data,analysis of bilateral hippocampal spectrum data and scale scores,and correlation analysis of differences between the results and the course of disease after chemotherapy.Results There was no significant difference in AVLT-H and digital breadth test scores between the two groups of subjects(P>0.05).The right hippocampal choline concentration in the breast cancer group was higher than that in the control group(14.39±3.27 vs.12.38±3.22,t=2.46,P=0.02),and the left hippocampus N-acetylaspartate(NAA)/creatine value was lower in the control group(1.23±0.18 vs.1.35±0.24,t=-2.15,P=0.04).Compared with the control group,the NAA,creatine concentration,choline concentration,and choline/creatine value on the left side of the breast cancer group were not statistically significant(P>0.05).In the breast cancer group,the NAA/creatine value of the left hippocampus and the concentration of choline on the right hippocampus were not significantly correlated with the course of the disease after chemotherapy(r=-0.22,-0.04,P>0.05).Conclusion The metabolism of hippocampus in survivors of breast invasive ductal carcinoma who received standard EC-T chemotherapy is still abnormal,and this meta

关 键 词：癌 导管 乳腺 药物疗法 磁共振成像 磁共振波谱学 记忆障碍 海马 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]