摘要
目的:探讨氢质子磁共振波谱(1H-MRS)在早产儿脑室周围白质软化(PVL)早期预测的价值。方法:对29例经常规MRI随访证实的早产儿PVL患者(病例组)和同期29例经常规MRI随访证实颅脑正常的早产儿(对照组)的头颅1H-MRS检查测得的代谢物NAA/Cr、Cho/Cr、Lac/Cr、Glx/Cr、mI/Cr进行比较和统计学分析。两组头颅1H-MRS均采用点分辨波谱(PRESS)序列,运用化学位移成像(CSI)技术行多体素检查,扫描野主要包括两侧侧脑室前后角周围白质,1H-MRS检查及首次常规MRI检查在出生后3～5天内完成,2次常规MRI随访分别在出生后第4周、8周或12周完成;用独立两样本t检验分析病例组与对照组各种代谢物比值的差异。结果:两组中均见明显的NAA、Cho、Cr、mI峰,其中Cho常为最高峰。29例病例组中,20例见较明显的Lac峰,6例见低平的Lac峰,3例未检测到Lac;18例见明显的Glx峰,10例见低平Glx峰,1例未检测到Glx峰。29例对照组中,26例见低平的Glx峰,15例见低平的Lac峰。病例组Lac/Cr、Glx/Cr明显高于对照组,差异有统计学意义(P值分别为0.005和0.002);两组间NAA/Cr、Cho/Cr、mI/Cr差异均无统计学意义(P值分别为0.24、0.18和0.17)。结论:早产儿PVL患者早期头颅1H-MRS有特征性,Lac/Cr、Glx/Cr升高可预测PVL的发生,为临床早期干预提供帮助。
Objective：To investigate the values of proton magnetic resonance spectroscopy（1H-MRS） in the early detection of periventricular leukomalacia（PVL） in preterm infants.Methods：1H-MRS examination of brain were performed in 29 cases preterm infants with PVL（case group） and 29 cases normal preterm infants（control group）,which were confirmed by conventional MRI follow-up.Point resolved spectroscopy（PRESS） 1H-MRS sequence were performed in two groups,using chemical shift imaging（CSI） and multi-voxel inspection,field of view including the cerebral white matter around the lateral ventricles.1H-MRS and the first conventional MRI examination were finished in the first 3～5 days after birth,and the two times follow-up conventional MRI examination were performed at 4,8 th or 12 th weeks in turn after birth.Metabolites of NAA/Cr,Cho/Cr,Lac/Cr,Glx/Cr,mI/Cr measured in two groups were compared and statistically analyzed suing independent two-sample t test analysis.Results：Obviously high peaks of NAA,Cho,Cr,mI were seen in both groups,of which Cho is the highest peak usually.In the patient group,18 cases had high Glx peaks,10 cases had low Glx peaks,1 case did not have Glx peak;20 cases had obvious Lac peaks,6 cases had low Lac peaks,3 cases did not have Lac peaks.In the control group,26 cases had low Glx peaks,15 cases had obviously low Lac peaks.Lac / Cr and Glx / Cr were statistically significant between the two groups.The differences of NAA/Cr,Cho/Cr,mI/Cr between the two groups were not statistically significant.Conclusion：The early 1H-MRS examination of preterm infants PVL has characteristic features.The increase of Glx/Cr and Lae/Cr can forecast PVL occurrence,and Early brain 1H-MRS is helpful to deteraine the early clinical intervention.
出处
《医学影像学杂志》
2011年第6期806-810,共5页
Journal of Medical Imaging
关键词
氢质子磁共振波谱
早产儿
脑室周围白质软化
预测
Proton magnetic resonance spectroscopy
Preterm infant
Periventricular leukomalacia
Forecast
