Bruneteau G, Guillevin R, Tourbah A, Papeix C, Chiras J, Pierrot-Deseilligny C
Service de Neurologie 1, Hôpital de la Salpêtrière, Paris.
Rev Neurol (Paris). 2005 Apr;161(4):455-8. doi: 10.1016/s0035-3787(05)85076-3.
Balo's concentric sclerosis is a neuropathological type of multiple sclerosis characterized by alternating rings of spared myelin and demyelination. Diagnosis is based on MRI, but very few data are available concerning the lesion features using serial proton magnetic resonance spectroscopy (1H-MRS).
We report 1H-MRS initial findings and disease course in one case of Balo's concentric sclerosis.
The first 1H-MRS study of 2 concentric ring-enhanced lesions showed a decreased N-acetyl-aspartate (NAA) peak, an increased choline peak, 2 broad lactate peaks and the presence of a lipid peak at 0.9 ppm. Six months later, 1H-MRS showed a decrease of choline peak, whereas the lactate peak had disappeared. The NAA peak was still at a low level.
These findings are similar to those reported in demyelinating disorders, such as multiple sclerosis. Thus, in Balo's concentric sclerosis, 1H-MRS may provide neurochemical arguments for inflammation and demyelination, and indicate the severity of axonal damage and recovery.
巴洛同心硬化是一种多发性硬化的神经病理学类型，其特征为髓鞘保留区和脱髓鞘区交替出现的环形结构。诊断主要基于磁共振成像（MRI），但关于使用连续质子磁共振波谱（1H-MRS）的病变特征的数据非常少。
我们报告了一例巴洛同心硬化患者的1H-MRS初始检查结果及病程。
对两个同心环形强化病变进行的首次1H-MRS研究显示，N-乙酰天门冬氨酸（NAA）峰降低，胆碱峰升高，有两个宽的乳酸峰，且在0.9 ppm处有脂质峰。六个月后，1H-MRS显示胆碱峰降低，而乳酸峰消失。NAA峰仍处于低水平。
这些发现与脱髓鞘疾病（如多发性硬化）中报告的结果相似。因此，在巴洛同心硬化中，1H-MRS可为炎症和脱髓鞘提供神经化学依据，并提示轴突损伤和恢复的严重程度。
