论文部分内容阅读
目的:探讨氢质子磁共振波谱(1H-MRS)在早产儿脑室周围白质软化(PVL)早期预测的价值。方法:对29例经常规MRI随访证实的早产儿PVL患者(病例组)和同期29例经常规MRI随访证实颅脑正常的早产儿(对照组)的头颅1H-MRS检查测得的代谢物NAA/Cr、Cho/Cr、Lac/Cr、Glx/Cr、mI/Cr进行比较和统计学分析。两组头颅1H-MRS均采用点分辨波谱(PRESS)序列,运用化学位移成像(CSI)技术行多体素检查,扫描野主要包括两侧侧脑室前后角周围白质,1H-MRS检查及首次常规MRI检查在出生后3～5天内完成,2次常规MRI随访分别在出生后第4周、8周或12周完成;用独立两样本t检验分析病例组与对照组各种代谢物比值的差异。结果:两组中均见明显的NAA、Cho、Cr、mI峰,其中Cho常为最高峰。29例病例组中,20例见较明显的Lac峰,6例见低平的Lac峰,3例未检测到Lac;18例见明显的Glx峰,10例见低平Glx峰,1例未检测到Glx峰。29例对照组中,26例见低平的Glx峰,15例见低平的Lac峰。病例组Lac/Cr、Glx/Cr明显高于对照组,差异有统计学意义(P值分别为0.005和0.002);两组间NAA/Cr、Cho/Cr、mI/Cr差异均无统计学意义(P值分别为0.24、0.18和0.17)。结论:早产儿PVL患者早期头颅1H-MRS有特征性,Lac/Cr、Glx/Cr升高可预测PVL的发生,为临床早期干预提供帮助。
Objective: To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) in the early prediction of periventricular leukomalacia (PVL) in preterm infants. Methods: Totally 29 patients with PVL confirmed by routine MRI follow-up (case group) and 29 normal subjects with MRI confirmed by skull normal 1H-MRS (control group) / Cr, Cho / Cr, Lac / Cr, Glx / Cr, mI / Cr were compared and analyzed statistically. 1H-MRS of both groups used point-resolution spectroscopy (PRESS) sequence, using chemical shift imaging (CSI) technique to perform multi-voxel examination. The scanning fields mainly included white matter around the anterior and posterior horn of both sides of the lateral ventricle, 1H-MRS and the first routine The MRI examination was completed within 3 to 5 days after birth and two routine MRI follow-up were completed at the 4th, 8th or 12th week after birth respectively. The differences of the ratios of the metabolites between the case group and the control group were analyzed by independent two-sample t-test . Results: The obvious NAA, Cho, Cr, mI peaks were observed in both groups, of which Cho was the highest peak. Of the 29 cases, 20 had a marked Lac peak, 6 had a low Lac peak, 3 had no Lac detected, 18 had a clear Glx peak, 10 had a low Gln peak, and 1 had not Glx peak was detected. In the 29 cases of control group, 26 cases showed low flat Glx peak and 15 cases showed low flat Lac peak. The Lac / Cr, Glx / Cr in the case group were significantly higher than those in the control group (P = 0.005 and 0.002 respectively). There was no significant difference in NAA / Cr, Cho / Cr and mI / Cr between the two groups (P values were 0.24, 0.18 and 0.17, respectively). CONCLUSION: 1H-MRS in early stage of PVL in preterm infants is characteristic. Elevated Lac / Cr and Glx / Cr levels may predict the occurrence of PVL and provide early clinical intervention.