Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China.
J Magn Reson Imaging. 2011 Oct;34(4):910-6. doi: 10.1002/jmri.22706. Epub 2011 Jul 19.
To explore the value of proton magnetic resonance spectroscopy imaging ((1)H-MRSI) in patients with stenosis or occlusion of the internal carotid artery (ICA) / middle cerebral artery (MCA).
Fifty noninfarcted patients with stenosis or occlusion of unilateral ICA/MCA were included in our study. In the meantime, 25 patients with cerebral infarction and 25 healthy control subjects were enrolled. All patients and healthy control subjects underwent (1)H-MRSI. Cerebral metabolic changes were studied in the noninfarcted patients and compared with the infarcted patients as well as healthy control subjects.
In 50 noninfarcted patients N-acetylaspartate (NAA) decreased and choline increased in the ischemic hemisphere compared with the contralateral side and control subjects. Lactate peaks were observed in 12 patients. The metabolic changes were relatively slight but were associated with metabolic disruption in infarcted patients. There were relationships between metabolic abnormalities and neurological status of the noninfarcted patients.
(1)H-MRSI can demonstrate abnormal metabolic changes in cerebral tissues with no infarction, while with ICA/MCA may show stenosis or occlusion at an early stage, which may help guide treatment decisions and preoperative evaluation.
探讨质子磁共振波谱成像（(1)H-MRSI）在颈内动脉（ICA）/大脑中动脉（MCA）狭窄或闭塞患者中的应用价值。
本研究纳入了 50 例单侧 ICA/MCA 狭窄或闭塞的非梗死患者，同时纳入了 25 例脑梗死患者和 25 例健康对照者。所有患者和健康对照者均行（1）H-MRSI 检查。研究非梗死患者的脑代谢变化，并与梗死患者及健康对照者进行比较。
在 50 例非梗死患者中，与对侧和对照组相比，缺血侧的 N-乙酰天冬氨酸（NAA）降低，胆碱增加。12 例患者出现乳酸峰。代谢变化相对轻微，但与梗死患者的代谢紊乱有关。非梗死患者的代谢异常与神经状态之间存在一定的关系。
(1)H-MRSI 可显示无梗死的脑组织异常代谢变化，而 ICA/MCA 狭窄或闭塞患者可能在早期出现，这有助于指导治疗决策和术前评估。
