CAJ | 학술논문

目的探讨脑泡型包虫病(CAE)的1H MRS特点.方法 13例经病理诊断(7例)和临床诊断(6例)为CAE患者(共33个病灶),应用3.0T双梯度超导MR仪,进行常规MR和2D多体素1H MRS检查,检测病灶实质区和对侧相应部位正常脑实质区胆碱(Cho)、N-乙酰天冬氨酸(NAA)、肌酸(Cr)、脂质+乳酸(Lip+Lac)、肌醇(mI)等代谢物的浓度,并计算Cho/Cr、NAA/Cr、(Lip+ Lac)/Cr、mI/Cr值,对各组数据采用Wilcoxon符号秩和检验进行统计学分析.结果脑泡型包虫病(病灶实质区)的谱线特点表现为Cho、NAA峰不同程度地降低,明显的Lip峰伴或不伴Lac峰.CAE病灶实质区和正常脑实质区Cho/Cr、NAA/Cr、(Lip+ Lac)/Cr、mI/Cr值的中位数和四分位数范围分别为1.88(1.24 ～2.23)、1.32(1.07 ～1.58)、32.96(24.59～ 47.30)、0.91(0.67～1.08)和0.84(0.70～ 0.98)、2.00(1.80 ～2.18)、0.90(0.74 ～0.99)、0.26(0.18 ～0.31),NAA/Cr明显下降,Cho/Cr、mI/Cr轻度升高,(Lip+ Lac)/Cr值明显升高,差异均有统计学意义(Z值分别为-5.932、-6.086、-6.946、-6.984,P值均＜0.01).结论多体素1H MRS检查可以反映CAE的病理特点,为其诊断提供代谢信息,是常规MR检查的必要补充.
목적 탐토뇌포형포충병(CAE)적1H MRS특점.방법 13례경병리진단(7례)화림상진단(6례)위CAE환자(공33개병조),응용3.0T쌍제도초도MR의,진행상규MR화2D다체소1H MRS검사,검측병조실질구화대측상응부위정상뇌실질구담감(Cho)、N-을선천동안산(NAA)、기산(Cr)、지질+유산(Lip+Lac)、기순(mI)등대사물적농도,병계산Cho/Cr、NAA/Cr、(Lip+ Lac)/Cr、mI/Cr치,대각조수거채용Wilcoxon부호질화검험진행통계학분석.결과 뇌포형포충병(병조실질구)적보선특점표현위Cho、NAA봉불동정도지강저,명현적Lip봉반혹불반Lac봉.CAE병조실질구화정상뇌실질구Cho/Cr、NAA/Cr、(Lip+ Lac)/Cr、mI/Cr치적중위수화사분위수범위분별위1.88(1.24 ～2.23)、1.32(1.07 ～1.58)、32.96(24.59～ 47.30)、0.91(0.67～1.08)화0.84(0.70～ 0.98)、2.00(1.80 ～2.18)、0.90(0.74 ～0.99)、0.26(0.18 ～0.31),NAA/Cr명현하강,Cho/Cr、mI/Cr경도승고,(Lip+ Lac)/Cr치명현승고,차이균유통계학의의(Z치분별위-5.932、-6.086、-6.946、-6.984,P치균＜0.01).결론 다체소1H MRS검사가이반영CAE적병리특점,위기진단제공대사신식,시상규MR검사적필요보충.
Objective To investigate the characteristics of proton magnetic resonance spectroscopy (1H MRS) in patients with cerebral alveolar echinococcosis (CAE).Methods Thirteen patients with 33 lesions proven to be CAE histologically and clinically were examined by conventional MRI and 2D multivoxel spectroscopy with a 3.0 T double gradient superconductivity magnetic resonance scanner.Concentrations of the metabolites containing N-acetyl-aspartic-acid (NAA),Choline (Cho),Creatine (Cr),lipids and lactic acid (Lip + Lac),myo-Inositol (mI) were detected and the value of Cho/Cr,NAA/Cr,(Lip + Lac)/Cr,mI/Cr were calculated.The values of Cho/Cr,NAA/Cr,(Lip + Lac)/Cr,mI/Cr were compared between the lesions and the contralateral normal brain parenchyma.Statistical analysis was performed using the Wilcoxon signed-rank test.Results CAE 1H MRS in the lesions was characterized by the decrease of Cho,NAA to varying degrees,and a visible lipid with or without lactate peak.Compared with the control group,the ratio of NAA/Cr was decreased markedly,whereas Cho/Cr,mI/Cr increased mildly and (Lip + Lac)/Cr increased markedly in the lesions.The medians and interquartile ranges of Cho/Cr,NAA/Cr,(Lip + Lac)/Cr and mI/Cr in the lesions were:1.88 (1.24-2.23),1.32 (1.07-1.58),32.96 (24.59-47.30) and 0.91 (0.67-1.08),respectively.The medians and interquartile ranges of Cho/Cr,NAA/Cr,(Lip + Lac)/Cr and mI/Cr of control group were 0.84(0.704-0.98),2.00(1.80-2.18),0.90 (0.74-0.99) and 0.26 (0.18-0.31),respectively.There were statistically significant differences of the measures between the lesions and the control regions (Z =-5.932,-6.086,-6.946,-6.984,P ＜0.01).Conclusions Multi-voxel 1H MRS can reflect pathological characteristics of CAE.1 H MRS provides metabolic information for diagnosis of CAE and may be a supplement to conventional magnetic resonance examination.