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目的探讨颅脑外伤(TBI)所致脑桥代谢物变化规律及其与预后的关系。方法对34例TBI患者行快速波谱成像(TSI),获得NAA/Cr、Cho/Cr、Cho/NAA值,并与16例正常志愿者(对照组)进行对比。将TBI组根据格拉斯哥预后评分分为预后良好、中等、差3组,比较不同组间代谢物水平差别。结果 TBI组34例脑桥NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.51±0.73、2.56±0.67、1.05±0.29;对照组16例NAA/Cr、Cho/Cr、Cho/NAA均值分别为2.70±0.37、1.92±0.09、0.72±0.08。两组间NAA/Cr均值差异无统计学意义(P=0.235),两组间Cho/Cr、Cho/NAA均值差异有显著统计学意义(P值均=0.000)。NAA/Cr在预后差组(2.15±0.56)与预后中等组(2.73±0.58)之间、预后差与预后良好组(2.98±0.90)间差异有统计学意义(P值分别为0.036、0.007)。Cho/Cr 3组之间差异无统计学意义。Cho/NAA在预后差组(1.22±0.31)与预后良好组(0.80±0.15)之间差异有统计学意义(P=0.001)。结论 TSI适合TBI脑桥MRS检测,TBI患者脑桥Cho/Cr和Cho/NAA较正常人升高,而NAA/Cr和Cho/NAA比值对TBI预后判断较有意义。
Objective To investigate the changes of psoriasis metabolites induced by traumatic brain injury (TBI) and its relationship with prognosis. Methods 34 patients with TBI underwent fast spectral imaging (TSI), NAA / Cr, Cho / Cr, Cho / NAA values, and with 16 normal volunteers (control group) were compared. According to the Glasgow prognostic score, the TBI group was divided into three groups with good prognosis, moderate difference and poor difference in metabolite levels. Results The NAA / Cr, Cho / Cr and Cho / NAA of 34 cases in TBI group were 2.51 ± 0.73, 2.56 ± 0.67 and 1.05 ± 0.29, respectively. The NAA / Cr, Cho / Cr and Cho / NAA in control group were 2.70 ± 0.37, 1.92 ± 0.09, 0.72 ± 0.08. There was no significant difference in mean NAA / Cr between the two groups (P = 0.235). The difference of Cho / Cr, Cho / NAA between the two groups was statistically significant (P = 0.000). The difference of NAA / Cr between the poor prognosis group (2.15 ± 0.56) and the moderate prognosis group (2.73 ± 0.58), the poor prognosis group and the good prognosis group (2.98 ± 0.90) were statistically significant (P = 0.036,0.007) . There was no significant difference between Cho / Cr 3 groups. The difference of Cho / NAA between the poor prognosis group (1.22 ± 0.31) and the good prognosis group (0.80 ± 0.15) was statistically significant (P = 0.001). Conclusion TSI is suitable for MRS detection of TBI pons. The Cho / Cr and Cho / NAA of pons in patients with TBI are higher than those in normal subjects. The ratio of NAA / Cr and Cho / NAA is of great significance for the prognosis of TBI.