摘要
目的比较短暂性脑缺血发作(TIA)和脑梗死的氢质子磁共振波谱(1H-MRS)改变,探讨1H-MRS在TIA中的应用价值。资料与方法对30例TIA和24例脑梗死患者行1H-MRS检查,同期选择24名健康志愿者作为对照。分别比较TIA患者病变侧和对侧半卵圆中心、脑梗死患者梗死灶与对侧正常脑组织代谢物氮-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)含量的差异,并观察有无乳酸(Lac)峰出现,再对TIA患者、脑梗死患者及正常对照组之间脑内NAA、Cho、Cr和Lac含量的差异进行比较。结果TIA患者病变侧半卵圆中心NAA降低、Cho升高,与对侧相应区域以及正常对照组比较差异均有统计学意义(P<0.01),而两侧Cr含量差异无统计学意义(P>0.05),脑梗死患者梗死灶内NAA、Cho和Cr与对侧正常脑组织和正常对照组比较均有下降,差异有统计学意义(P<0.01),但TIA患者NAA下降幅度明显小于脑梗死患者,差异有统计学意义(P<0.01);10例TIA患者、23例脑梗死患者于病侧发现Lac峰,TIA的Lac含量低于脑梗死,差异有统计学意义(P<0.01)。结论TIA患者缺血脑组织存在代谢异常,但较脑梗死轻微,1H-MRS能够早期发现这种异常,对TIA的早期诊断和治疗具有重要价值。
Objective To compare the metabolic changes in transient ischemic attacks （TIA） and cerebral infarction by 1^H magnetic resonance spectroscopy （1^H-MRS） , and to explore the value of 1^H-MRS on TIA. Materials and Methods 1^H-MRS were performed in 30 patients with TIA and 24 with infarction and 24 control subjects. Cerebral metabolism was studied by assessing peak areas of N acetyl aspartate （NAA） , choline （Cho） and creatine （Cr） as well as peak height ratio of lactate（Lac） to Cr on the both sides. Results In TIA patients, decreased NAA and increased Cho were found in the symptomatic centrum semiovale compared with the asymptomatic side and the control subjects （ P 〈 0.01 ） . The concentrations of Cr had no obvious changes （P 〉 0.05）. In cerebral infarction patients, the concentrations of NAA, Cho and Cr were all significantly decreased in the lesion compared with the contralateral noninfarcted areas and the control subjects （ P 〈 0.01 ） . But NAA did not decrease in TIA as severely as that in infarction（ P 〈 0.01 ）. Lac was observed in 10 TIA patients and 23 cerebral infarction patients. The Lac/Cr ratio of the TIA patients was lower than that of the cerebral infarction patients （ P 〈 0.01 ） . Conclusion The abnormal metabolic changes could be found in TIA, but were not as severe as those in cerebral infarction.1^H-MRS could provide valuable information about metabolic changes in TIA and play an important role in the diagnosis and treatment of TIA.
出处
《临床放射学杂志》
CSCD
北大核心
2007年第5期430-434,共5页
Journal of Clinical Radiology
基金
北京市优秀人才培养资助项目(20042D0501809)
关键词
脑缺血
短暂性
脑梗死
氢质子磁共振波谱
磁共振成像
Cerebral isehemia, transient Cerebral infarction 1^H Magnetic resonance spectroscopy Magnetic resonance imaging
