Abe K, Yoshimura H, Tanaka H, Fujita N, Hikita T, Sakoda S
Department of Neurology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871 Osaka, Japan.
Neuroradiology. 2004 Feb;46(2):113-7. doi: 10.1007/s00234-003-1138-2. Epub 2003 Dec 12.
The mechanism of neurological disturbances in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is controversial. We studied 12 patients with MELAS using conventional and diffusion weighted MRI (DWI) and MR spectroscopy (MRS), to look at the physiopathology of the stroke-like events. Although conventional MRI showed lesions in all patients, DWI was more sensitive. One patient did not show high signal on DWI 48 h after a from stroke-like episode, but MRS demonstrated a lactate peak in left occipital lobe; 2 weeks after the attack, high signal was demonstrated on the right frontal lobe where MRS had shown a lactate peak. Our findings suggest a possible predictive ability of (1)H-MRS, in showing early MELAS lesions and supports the hypothesis that mitochondrial metabolic dysfunction may precedes abnormalities on DWI.
线粒体肌病、脑病、乳酸酸中毒和卒中样发作（MELAS）患者神经功能障碍的机制存在争议。我们使用传统磁共振成像（MRI）、扩散加权成像（DWI）和磁共振波谱（MRS）对12例MELAS患者进行了研究，以观察卒中样事件的生理病理学。尽管传统MRI在所有患者中均显示有病变，但DWI更敏感。1例患者在卒中样发作后48小时DWI未显示高信号，但MRS显示左枕叶有乳酸峰；发作2周后，右侧额叶显示高信号，而之前MRS在此处显示有乳酸峰。我们的研究结果表明，氢质子磁共振波谱（1H-MRS）可能具有预测早期MELAS病变的能力，并支持线粒体代谢功能障碍可能先于DWI异常的假说。
