成人轻中型颅脑损伤挫裂伤区域的多体素H-MRS研究.docVIP

成人轻中型颅脑损伤挫裂伤区域的多体素1H-MRS研究 张 扬，黎海涛，谢 斌，黎 川（第三军医大学西南医院放射科，重庆400038） 摘 要：目的NAA /Cho及Cho /Cr平均值与正常对照组比较有显著性差异（P0.01）；轻、中型组间比较，NAA /Cr值有显著性差异（P0.01），而两组的NAA /Cho和Cho /Cr值则无显著性差异（P0.05）。结论 多体素1H-MRS分析对轻中型TBI的早期诊断及伤情的评估有重要价值，损伤区NAA/Cr值的变化能客观地反映脑损伤的严重程度。 关键词：质子磁共振波谱；创伤性颅脑损伤；格拉斯哥昏迷评分 中图法分类号： 文献标识码：A A study on contusion and laceration area of mild-to-moderate traumatic brain injury with multivoxel 1H-MRS in adults ZHANG Yang, LI Hai-tao, XIE Bin, LI Chuan (Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038,China) Abstract: Objective To investigate the value of multivoxel proton magnetic resonance spectroscopy (1H-MRS) in contusion and laceration area of mild-to-moderate traumatic brain injury in adults. Methods Sixteen TBI patients diagnosed specifically were recruited in this study, contusion and laceration area in the spectrum for NAA, Cho, Cr and other metabolite peaks were measure and NAA /Cr, NAA /Cho, Cho /Cr ratios were calculated for each voxel. Results In multivoxel 1H-MRS from the lesion areas, the ratios of NAA /Cr, NAA /Cho and Cho /Cr changed significantly when compared with that of normal control group(P0.01), and the NAA/Cr levels of contusion and laceration area in the group of moderates was significantly lower than the milds (P0.01),but both the ratios of NAA /Cho and Cho /Cr were not statistically significant different between the moderates and the milds. Conclusion Multivoxel 1H-MRS may have an important clinical value in detecting and assessing early mild-to-moderate brain trauma, the NAA/Cr ratios in injured region can reflect the severity of cerebral injury objectively. Key Words: Proton magnetic resonance spectroscopy; Traumatic brain injury; Glasgow coma score 创伤性脑损伤(traumatic brain injuryTBI)是当今社会成人致残和死亡的主要原因之一，其中约有85%～95%的患者被诊断为轻中型颅脑损伤[1]。他们中的多数是处于社会中流砥柱的年轻人，由于神经功能障碍不能重返工作岗位或参加社会活动，不仅关系个人更影响社会经济的发展，已成为严重的社会问题[2]。目前对重型、儿童颅脑损伤的相关报道颇多，而成人轻型、中型损伤的研究比较少，本研究采用质子yy_998