CAJ | 학술논문

目的观察慢性酒精依赖(CAD)患者双侧海马体积变化及1H-MRS表现,为CAD患者的临床诊断起量化指导作用.方法选取临床确诊的16例CAD患者(CAD组)和18名正常志愿者(对照组)分别进行MR常规扫描、三维快速扰相位梯度回波(3D-FSPGR)扫描以及海马1H-MRS扫描,分别测量两组受试者海马体积,并对CAD组及对照组的双侧海马标准化体积进行比较;测量两组双侧海马头部的N-乙酰天冬氨酸(NAA)、胆碱(Cho)、肌醇(ml)以及肌酸(Cr),对Cho/Cr、Cho/NAA、NAA/Cr及mI/Cr比值进行比较.两组间海马体积及双侧海马头部1H-MRS监测值的比较采用t检验.结果 CAD组左、右侧海马体积分别为1.881±0.292、2.139±0.328,对照组分别为2.106±0.245、2.267-±0.271,CAD组及对照组内左、右侧海马体积差异无统计学意义(t值分别为0.232、0.147,P值均＞0.05);两组间左、右侧海马体积差异也无统计学意义(t值分别为0.424、0.131,P值均＞0.05).CAD组的右侧海马头部Cho/Cr、NAA/Cr分别为1.225±0.210、1.145±0.034,对照组分别为1.429±0.286、1. 612±0.444,两组间差异有统计学意义(t值分别为0.321、0.408,P值均＜0.05).两组间海马头部右侧Cho/NAA、mI/Cr及左侧Cho/Cr、Cho/NAA、NAA/Cr及mI/Cr差异均无统计学意义.结论 CAD患者尚未出现脑组织形态学改变之前,1H-MRS的表现具有为临床早期诊断提供客观量化依据的潜能.
목적 관찰만성주정의뢰(CAD)환자쌍측해마체적변화급1H-MRS표현,위CAD환자적림상진단기양화지도작용.방법 선취림상학진적16례CAD환자(CAD조)화18명정상지원자(대조조)분별진행MR상규소묘、삼유쾌속우상위제도회파(3D-FSPGR)소묘이급해마1H-MRS소묘,분별측량량조수시자해마체적,병대CAD조급대조조적쌍측해마표준화체적진행비교;측량량조쌍측해마두부적N-을선천동안산(NAA)、담감(Cho)、기순(ml)이급기산(Cr),대Cho/Cr、Cho/NAA、NAA/Cr급mI/Cr비치진행비교.량조간해마체적급쌍측해마두부1H-MRS감측치적비교채용t검험.결과 CAD조좌、우측해마체적분별위1.881±0.292、2.139±0.328,대조조분별위2.106±0.245、2.267-±0.271,CAD조급대조조내좌、우측해마체적차이무통계학의의(t치분별위0.232、0.147,P치균＞0.05);량조간좌、우측해마체적차이야무통계학의의(t치분별위0.424、0.131,P치균＞0.05).CAD조적우측해마두부Cho/Cr、NAA/Cr분별위1.225±0.210、1.145±0.034,대조조분별위1.429±0.286、1. 612±0.444,량조간차이유통계학의의(t치분별위0.321、0.408,P치균＜0.05).량조간해마두부우측Cho/NAA、mI/Cr급좌측Cho/Cr、Cho/NAA、NAA/Cr급mI/Cr차이균무통계학의의.결론 CAD환자상미출현뇌조직형태학개변지전,1H-MRS적표현구유위림상조기진단제공객관양화의거적잠능.
Objective To observe the changes of the bilateral hippocampal volume (BHV) and 1H-MRS appearance of chronic alcohol dependent (CAD) patients and to provide quantitative information for the clinical diagnosis of CAD. Methods The conventional MR imaging including three-dimensional fast spoiled gradient recalled echo (3D-FSPGR) and 1H-MRS were performed on 16 patients with CAD (CAD group)and 18 cases of volunteer ( control group). The BHV were measured in both groups and the standardized BHV in CAD group and control group were compared. 1H-MRS metabolites including N-acetylaspartate (NAA), Choline compounds (Cho), Creatine (Cr), and myoinositol (mI) of the bilateral cephalic hippocampus were acquired. The ratios of Cho/Cr, Cho/NAA, NAA/Cr and mI/Cr within the bilateral cephalic hippocampus of the two groups were compared. The t test was used to compare the BHV and the ratios of 1H-MRS in the bilateral cephalic hippocampus between the two groups. Results In CAD group,the left and the right hippocampal volume were 1. 881 ±0. 292, 2. 139 ±0. 328 respectively while they were 2. 106 ±0. 245 and 2. 267 ±0. 271 respectively in the control group. The BHV had no significant difference between the left and the right in either the CAD group or the control group (t =0. 232, 0. 147 respectively,P ＞ 0. 05). The BHV had no significant difference between the CAD group and control group(t = 0. 424,0. 131 respectively ,P ＞0. 05 ). The Cho/Cr and NAA/Cr in the right cephalic hippocampus of the CAD group were 1. 225 ±0. 210 and 1. 145 ±0. 034 respectively, while they were 1. 429 ±0. 286, 1. 612 ±0. 444 respectively in the control group(t =0. 321,0. 408 ,P ＜0. 05 ). The Cho/NAA, mI/Cr in the right cephalic hippocampus and the Cho/Cr, Cho/NAA, NAA/Cr and mI/Cr in the left cephalic hippocampus between the two groups had no statistically significant difference. Conclusion 1H-MRS could potentially provide early diagnostic evidence for CAD patients before the onset of cerebral morphological changes.