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目的探讨长回波(echo time,TE)点分辨率波谱(point resolved spectroscopy,PRESS)和激励回波采集模式(stimulated echo acquisition mode,STEAM)2种2-D氢质子磁共振波谱(proton magnetic resonance spectroscopy,1H-MRS)在多发性硬化(multiple sclerosis,MS)病灶及看似正常表现脑白质(normal appearing white matter,NAWM)中的价值。方法对56例复发-缓解型MS(relapsing-remitting MS,RRMS)患者和25例健康志愿者行常规磁共振成像(conventional magneticresonance imaging,cMRI)扫描,并采用PRESSS长回波和STEAM短回波1H-MRS分析,测定各感兴趣区(region of interest,ROI)代谢物氮-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)、脂质(Lip)、乳酸(Lac)和肌醇(Ins)的浓度,分析NAA/Cr、Cho/Cr、NAA/Cho、Lac+Lip/Cr和Ins/Cr在病灶和NAWM区中的变化。结果①PRESS长回波显示NAA/Cr、Cho/Cr、NAA/Cho在急性病灶、慢性病灶和对照组相应脑白质(white matter,WM)区三者之间均有显著差异(P<0.01),NAA/Cr、NAA/Cho在急性病灶和慢性病灶间差异不显著(P>0.05);②STEAM短回波显示NAA/Cr、Cho/Cr和Lac+Lip/Cr在急性病灶、NAWM区和对照组相应WM区三者之间均有显著差异(P<0.01);③比较PRESS长回波和STEAM短回波对检测病灶平均代谢物的差异,结果示二者检测NAA/Cr和Cho/Cr无明显差别,但STEAM短回波更能检测到病灶内的Lip、Lac及Ins峰。结论 PRESS长回波和STEAM短回波能检测MS患者脑部病灶及NAWM区的代谢异常,但STEAM短回波较PRESS长回波能探测到更多代谢物。
Objective To investigate the effects of proton magnetic resonance spectroscopy (2-D hydrogen proton magnetic resonance spectroscopy) on echo time (TE) point resolved spectroscopy (PRESS) and stimulated echo acquisition mode (STEAM) spectroscopy (1H-MRS) in multiple sclerosis (MS) lesions and normal appearing white matter (NAWM). Methods 56 patients with relapsing-remitting MS (RRMS) and 25 healthy volunteers underwent conventional magnetic resonance imaging (cMRI). The patients were treated with PRESSS long echo and STEAM short echo 1H -MRS analysis was performed to determine the metabolites of each region of interest (ROI), including NAA, Cho, Cr, Lip, ) And inositol (Ins) were measured. The changes of NAA / Cr, Cho / Cr, NAA / Cho, Lac + Lip / Cr and Ins / Cr in lesions and NAWM were analyzed. Results ① The long echo of PRESS showed that NAA / Cr, Cho / Cr and NAA / Cho were significantly different between acute lesions, chronic lesions and corresponding white matter (WM) NAA / Cr and NAA / Cho were not significantly different between acute lesions and chronic lesions (P> 0.05). ② The short echo of STEAM showed that NAA / Cr, Cho / Cr and Lac + Lip / Cr in acute lesions, NAWM area and control group (P <0.01). (3) The difference of mean metabolites of lesion between PRESS long echo and STEAM short echo were compared. The results showed that both of them detected NAA / Cr and Cho / Cr Significantly different, but STEAM short echo more detection of lesions within the Lip, Lac and Ins peak. Conclusions The long-echo PRESS and STEAM short-echo can detect the metabolic abnormalities in brain lesions and NAWM in MS patients. However, STEAM short-echoes detect more metabolites than PRESS long-echo.