论文部分内容阅读
目的利用磁共振波谱(1H magnetic resonance spectroscopy,1H-MRS)探讨单侧颈内动脉(internal carotid artery,ICA)重度狭窄或闭塞性短暂性脑缺血发作(transient ischemic attack,TIA)的脑代谢改变。方法28例经数字减影血管造影(digital subtraction angiography,DSA)证实为单侧ICA重度狭窄或闭塞性TIA患者,应用3.0T MRI行1H-MRS检查,测量患侧和对侧大脑半球半卵圆中心的代谢物氮-乙酰天门冬氨酸(N-acetylaspartate,NAA)、胆碱(choline,Cho)、肌酸(creatine,Cr)的波峰下面积,比较两侧各代谢物峰下面积比值NAA/Cho、NAA/Cr和Cho/Cr的差异,并观察有无乳酸(lactate,Lac)峰。结果28例单侧ICA重度狭窄或闭塞的TIA患者,1H-MRS显示患侧半卵圆中心的NAA/Cho、NAA/Cr比值显著低于病变对侧(P<0.05),Cho/Cr比值显著高于病变对侧(P<0.05),5例患者于患侧出现Lac峰。结论1H-MRS能够早期发现ICA重度狭窄或闭塞性TIA患者的脑代谢异常,对于早期治疗和判断预后具有重要价值。
Objective To investigate the changes of brain metabolism in patients with severe stenosis or transient ischemic attack (TIA) of unilateral internal carotid artery (ICA) by 1H magnetic resonance spectroscopy (1H-MRS) . Methods Twenty-eight patients with severe or unilateral ICA with digital subtraction angiography (DSA) were examined by 1H-MRS at 3.0T MRI. The hemispheric hemisphere of ipsilateral and contralateral hemispheres The area under the peak of N-acetylaspartate (NAA), choline (Cho) and creatine (Cr), the metabolites in the center, / Cho, NAA / Cr and Cho / Cr, and observe the presence or absence of lactate (Lac) peak. Results In 28 TIA patients with severe unilateral ICA stenosis or occlusion, 1H-MRS showed that the ratio of NAA / Cho and NAA / Cr in the ipsilateral center was significantly lower than that in the contralateral (P <0.05) and the ratio of Cho / Cr was significant Higher than the opposite side of the lesion (P <0.05), and 5 cases showed Lac peak on the affected side. Conclusion 1H-MRS can detect cerebral metabolic abnormalities in patients with ICA severe stenosis or occlusive TIA early, which is of great value for early treatment and prognosis.