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痴呆症中的氢质子磁共振波谱分析

1H magnetic resonance spectroscopy in dementia.

作者信息

Kantarci K

机构信息

Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Br J Radiol. 2007 Dec;80 Spec No 2:S146-52. doi: 10.1259/bjr/60346217.

Abstract

Present data support the concept that (1)H magnetic resonance spectroscopy ((1)H MRS) may become an adjunct to clinical evaluation for differential diagnosis of dementia in the future. The value of (1)H MRS in monitoring the disease progression in dementia is expected to be in areas where group effects are sought such as monitoring effectiveness of therapies in drug trials. Elevation of myoinositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) and reduction in the neuronal integrity marker N-acetylaspartate to creatine (NAA/Cr) levels in individuals with mild cognitive impairment and pre-symptomatic Alzheimer's disease suggests that (1)H MRS may also be valuable in predicting future development of dementia and monitoring early disease progression for preventive therapies. Investigations of in vivo (1)H MRS as a marker for differential diagnosis and progression of dementia, however, has been limited to clinically confirmed cohorts and remains to be validated by histopathology at autopsy. Overall, MRS is a promising investigational technique in ageing and dementia at this time. The potential clinical application of MRS in ageing and dementia, however, is growing with technical advances in the field.

摘要

目前的数据支持这样一种观念,即氢磁共振波谱分析(¹H MRS)未来可能成为临床评估痴呆症鉴别诊断的辅助手段。¹H MRS在监测痴呆症疾病进展方面的价值预计体现在寻求群体效应的领域,比如在药物试验中监测治疗效果。轻度认知障碍和症状前阿尔茨海默病患者中,肌醇与肌酸比值(mI/Cr)、胆碱与肌酸比值(Cho/Cr)升高,以及神经元完整性标志物N-乙酰天门冬氨酸与肌酸比值(NAA/Cr)水平降低,这表明¹H MRS在预测痴呆症未来发展以及监测预防性治疗的早期疾病进展方面可能也具有价值。然而,将活体¹H MRS作为痴呆症鉴别诊断和病情进展标志物的研究仅限于临床确诊队列,仍有待尸检组织病理学验证。总体而言,目前MRS是衰老和痴呆症领域一项很有前景的研究技术。不过,随着该领域技术的进步,MRS在衰老和痴呆症方面的潜在临床应用正在不断增加。

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