研究氢质子磁共振波谱(1H—MRS)在缺血性脑梗死中应用价值.docVIP

研究氢质子磁共振波谱(1H—MRS)在缺血性脑梗死中应用价值 　　doi：10.3969/j.issn.1007-614x.2013.20.55 　　摘 要 目的：应用氢质子磁共振波谱（1H-MRS）研究缺血性脑梗死的代谢物绝对浓度的变换特点及其演变规律，探讨其在评估缺血性脑梗死中的价值。方法：通过表观扩散系数图（ADC图）精确定位氢质子磁共振波谱，采用绝对定量方法，对30例不同时期缺血性脑梗死患者的NAA、Cr、Cho、mI、lac代谢物绝对浓度含量的变化进行检测，观察不同分期脑梗死中各代谢物的变化特点。结果：在超急性期，脑梗死区NAA浓度较对侧下降，但仍保持较高的水平；Cr浓度亦较对侧轻度下降，Cho、mI浓度略有下降，lac浓度明显升高。在急性期，脑梗死区NAA、Cr、Cho、mI浓度均较对侧明显下降，其中NAA浓度下降最为显著，平均浓度只为对侧的18.9%，而lac浓度继续升高，并达到高峰。在亚急性期，脑梗死区NAA、Cr、Cho、mI浓度均较对侧明显下降，lac浓度开始下降，但仍持续较高水平。在慢性早期和晚期，NAA、Cr、Cho、mI浓度继续维持很低的水平。Cr、Cho、mI与NAA均有平行下降趋势，但没有NAA、Lac变化显著。结论：在脑梗死的MRS研究中，绝对定量技术能直观、准确地检测缺血脑组织内代谢物的动态演变过程，对深入研究脑梗死的发病机理有重要意义。 　　关键词 脑梗死 磁共振氢质子波谱 扩散加权成像 代谢物 　　Abstract Objective：Application of proton magnetic resonance spectroscopy （1H-MRS） transform characteristics and evolution law of ischemic cerebral infarction metabolite concentration，explore the value evaluation of ischemic cerebral infarction.Methods：The apparent diffusion coefficient diagram （ADC diagram） precise positioning of proton magnetic resonance spectroscopy，using the absolute quantification method，changes of 30 cases patients with different stages of ischemic cerebral infarction of NAA、Cr、Cho、mI、lac metabolites of absolute concentrations were detected to observe the different characteristics of each metabolite，changes in the staging of cerebral infarction.Results：In super acute period of cerebral infarction area，NAA concentration is on the side down，but still maintained a higher level；the concentration of Cr is slightly to the contralateral side down，Cho，mI concentration decreased slightly，the concentration of Lac increased significantly.In the acute phase of cerebral infarction area，NAA，Cr、Cho、mI concentration was lower than contralateral decreased significantly，NAA concentration decreased most significantly，the average concentration of side 18.9%，while the lac concentration continues to increase， and reached a peak.In the subacute stage of cerebral infarction area，NAA、Cr、Cho、mI concentration was lower than contralateral decreased si