氢质子磁共振波谱序列PRESS和STEAM-第三军医大学学报.docVIP

氢质子磁共振波谱PRESS和STEAM序列在多发性硬化病灶和看似正常表现脑白质区中的价值 曾 春1, 李咏梅1, 谢 鹏2, 吕发金1, 罗天友1, 陈 璇1, 王忠平1 （400016重庆，重庆医科大学附属第一医院：放射科1，神内科2） [摘要] 目的 探讨长回波(echo time, TE)点分辨率波谱(point resolved spectroscopy, PRESS)和激励回波采集模式(stimulated echo acquisition mode, STEAM)2种2-D氢质子磁共振波谱(proton magnetic resonance spectroscopy, 1H-MRS)在多发性硬化(multiple sclerosis, MS)病灶及看似正常表现脑白质(normal appearing white matter, NAWM)中的价值。方法 对56例复发-缓解型MS(relapsing-remitting MS, RRMS)患者和25例健康志愿者行常规磁共振成像(conventional magnetic resonance imaging, cMRI)扫描，并采用PRESSS长回波和STEAM短回波 1H-MRS(region of interest, ROI)代谢物氮-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)、脂质(Lip)、乳酸(Lac)和肌醇(Ins)的浓度，分析NAA/Cr、Cho/Cr、NAA/Cho、Lac+Lip/Cr和Ins/Cr在病灶和NAWM区中的变化。结果 ① PRESS长回波显示NAA/Cr、Cho/Cr、NAA/Cho在急性病灶、慢性病灶和对照组相应脑白质(white matter, WM)区三者之间均有显著统计学意义(P0.01)，NAA/Cr、NAA/Cho在急性病灶和慢性病灶间虽有差异，但无显著统计学意义(P0.05)；② STEAM短回波NAA/Cr、Cho/Cr和Lac+Lip/Cr在急性病灶、NAWM区和对照组相应WM区三者之间均有显著统计学意义(P0.01)；③ 比较PRESS长回波和STEAM短回波NAA/Cr和Cho/Cr无明显差别，但STEAM短回波Lip、Lac及Ins峰。结论PRESS长回波和STEAM短回波MS患者脑部病灶及NAWM区的代谢异常，但STEAM短回波PRESS长回波能探测到更多代谢物。 [关键词] 多发性硬化; 磁共振成像; 氢质子磁共振波谱 [中图法分类号] R744.51; R445.2 [文献标志码] A Values of PRESS and STEAM Sequence in Lesions and NAWM of Multiple Sclerosis with 1H-Magnetic Resonance Spectroscopy Zeng Chun, Li Yongmei1, Xie peng2, Lv Fajin1, Luo Tianyou1, Chen Xuan1, Wang Zhongping1 （ Department of Radiology1, Department of Neurology2, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China） [Abstract] Objective To explore the values of the two-Dimension proton magnetic resonance spectroscopy (1H-MRS)—long echo time (TE) point resolved spectroscopy (PRESS) and stimulated echo acquisition mode (STEAM) in the lesions and normal-appearing white matter (NAWM) of patients with multiple sclerosis (MS). Methods 56 relapsing-remitting MS (RRMS) patients and 25 healthy volunteers underwent with conventional MRI (cMRI), long TE PRESS sequence and short TE STEAM sequence of 1H-MRS. The ratios of N-acetylaspartic acid (NAA), choline (Cho), creatine (Cr), lip