摘要
目的应用质子磁共振波谱（H-MRS）,研究脑梗死亚急性期病灶不同区域间各代谢产物的变化规律。方法55例发病在3-5d以内的脑梗死患者,行弥散加权成像（DWI）定位病灶,然后运用^1H-MRS对病灶侧梗死灶的核心区、内缘区、外缘区、周围区1、周围区2和正常区组织以及病灶对侧（对照侧）相应部位的氮-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱化合物（Cho）等代谢产物的浓度变化进行波谱分析,同时计算比较不同部位代谢产物的相对浓度（rNAA、rCr、rCho）和Lac/Cho。结果与对照侧相应区域比较,病灶侧NAA由正常区至核心区逐步下降,Lac则逐步增高。病灶侧各区域间rNAA、Lac/Cho比较有显著差异（P〈0.01）;Cr和Cho的减低以核心区为主,内、外缘区则略有降低。结论DWI结合1H-MRS对代谢产物的定位分析,推测脑梗死亚急性期缺血灶周边仍有持续低灌注区域,可能存在血脑屏障受损和血管源性水肿。
Objective To study the changes of metabolites among different lesion areas in subacute stage of cerebral infarction with proton magnetic resonance spectroscopy （^1H-MRS）. Methods ^1H-MRS and diffusion-weighted imaging （DWI）were performed in all the 55 cases of subacute cerebral infarction within 3 -5 days. The metabolites of N-acetylaspartate （NAA） , creatine （Cr） , choline （Cho） and lactate （Lac） were analyzed at different areas （ core, inner rim, outer rim, peripheral 1, peripheral 2 and normal, and homologous area of contralateral hemisphere）, and the ratios of metabolites （rNAA, rCr, rCho and Lac/Cho ） were compared and analyzed. Results In subacute cerebral infarction, NAA was gradually decreased from normal area to the core of lesion area, while Lac was gradually increased. The rNAA and Lae/Cho in different regions of lesion were significantly different （ P 〈 0.01 ）. The decreases of Cr and Cho were more significant in core area than those in inner and outer rim. Conclusion The analysis of metabolites by DWI in combination of ^1H-MRS indicates that the persistent low-perfusion in subacute cerebral infarction may be associated with blood-brain barrier damage and vasogenic edema.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2007年第6期719-722,共4页
Journal of Shanghai Jiao tong University:Medical Science
关键词
脑梗死
核磁共振成像
波谱
cerebral infarction
magnetic resonance imaging
spectroscopy
