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1、探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、ml、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
2、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、ml浓度略有下降,lac浓度明显升高。在急性期,脑梗死区NAA、Cr.Cho、ml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、ml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^ml浓度继续维持很低的水平。Cr、Cho、ml与NAA均有平行下降趋势,但没有N
3、AA、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AbstractObjective:Applicationofprotonmagneticresonancespectroscopy(1H-MRS)transformcharacteristicsandevolutionlawofischemiccerebralinfarctionmetaboliteconc
4、entration,explorethevalueevaluationofischemiccerebralinfarction.Methods:Theapparentdiffusioncoefficientdiagram(ADCdiagram)precisepositioningofprotonmagneticresonancespectroscopy,usingtheabsolutequantifiedtionmethod,changesof30casespatientswithdifferentsta
5、gesofischemiccerebralinfarctionofNAA、Cr>Cho、ml、lacmetabolitesofabsoluteconcentrationsweredetectedtoobservethedifferentcharacteristicsofeachmetabolite,changesinthestagingofcerebralinfarction.ResuIts:Insuperacuteperiodofcerebralinfarctionarea,NAAconcentrati
6、onisonthesidedown,butstillmaintainedahigherlevel;theconcentrationofCrisslightlytothecontralateralsidedown,Cho,mlconcentrationdecreasedslightly,theconcentrationofLacincreasedsignificantly.Intheacutephaseofcerebralinfarctionarea,NAA,Cr、Cho、mlconcentrationwa
7、slowerthancontralateraldecreasedsignificantly,NAAconcentrationdecreasedmostsignificantly,theaverageconcentrationofside18.9%,whilethelacconcentrationcontinuestoincrease,andreachedapeak.Inthesubacutestageofcerebralinfarctionarea,NAA、Cr、Cho、mlconcentrationwa
8、slowerthancontralateraldecreasedsignificantly,lacconcentrationbegantodecline,butstillhighleveLInchronicearlyandlate,NAA、Cr、Cho>mlconcentrationtomaintainaverylowlevel,Cr、Cho、mlandNAAhaveparalleldownwardtrend,butnosig