扩散加权磁共振成像及波谱分析在肝豆状核变性诊断及随访中的作用

Role of diffusion weighted magnetic resonance imaging and spectroscopy in the diagnosis and follow-up of hepatolenticular degeneration.

作者信息

Xue Peng, Liu Yong, Ma Xiu-hua, Chen Yong, Zhang Si-jia

机构信息

Department of Radiology, Zhengzhou People's Hospital, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2012 Oct;34(5):497-502. doi: 10.3881/j.issn.1000-503X.2012.05.011.

DOI:10.3881/j.issn.1000-503X.2012.05.011

PMID:23134827

Abstract

OBJECTIVE

To explore the changes of different brain metabolites during hepatolenticular degeneration using diffusion weighted magnetic resonance imaging (DWI) and magnetic resonance spectroscopy (MRS) in patients with hepatolenticular degeneration and study the correlation of apparent diffusion coefficient(ADC) values and MRS with the different pathological changes.

METHODS

Totally 53 patients with hepatolenticular degeneration were enrolled in this study and divided into DWI high-signal group (n=31) and DWI low-signal group (n=22). Magnetic resonance scan, DWI, and spectroscopy were performed before treatment and 4 months after treatment. The changes of ADC value, N-acetyl aspartate (NAA)/creatine (Cr) ratio, and choline (Cho)/Cr ratio were recorded.

RESULTS

Before treatment, the NAA/Cr ratio was significantly higher in the DWI high-signal group than in DWI low-signal group (P=0.002), whereas ADC value and NAA/Cr ratio were significantly lower (P=0.004, P=0.014, respectively). After treatment, the NAA/Cr ratio was still significantly higher in the DWI high-signal group (P=0.036), while the differences of ADC value and Cho/Cr ratio showed no statistical deference (P>0.05). In the DWI high-signal group, the ADC value and NAA/Cr ratio were significantly elevated after treatment (P=0.006, P=0.008), whereas the Cho/Cr ratio showed no significant change (P>0.05). In the DWI low signal group, NAA/Cr ratio was significantly increased after treatment (P=0.015), while the ADC value and Cho/Cr ratio showed no significant change (P>0.05).

CONCLUSIONS

DWI combined MRS imaging can be used to evaluate the microscopic structure and metabolic changes during copper deposition and thus, compared with the conventional magnetic resonance imaging provide more information on metabolism. Therefore, they can be useful tools in the early diagnosis and efficacy evaluation of hepatolenticular degeneration.

摘要

目的

采用磁共振扩散加权成像（DWI）及磁共振波谱成像（MRS）探讨肝豆状核变性患者不同脑代谢物的变化，并研究表观扩散系数（ADC）值及MRS与不同病理改变的相关性。

方法

本研究共纳入53例肝豆状核变性患者，分为DWI高信号组（n = 31）和DWI低信号组（n = 22）。在治疗前及治疗4个月后进行磁共振扫描、DWI及波谱分析。记录ADC值、N - 乙酰天门冬氨酸（NAA）/肌酸（Cr）比值及胆碱（Cho）/Cr比值的变化。

结果

治疗前，DWI高信号组的NAA/Cr比值显著高于DWI低信号组（P = 0.002），而ADC值及NAA/Cr比值显著低于DWI低信号组（分别为P = 0.004，P = 0.014）。治疗后，DWI高信号组的NAA/Cr比值仍显著高于DWI低信号组（P = 0.036），而ADC值及Cho/Cr比值的差异无统计学意义（P > 0.05）。在DWI高信号组，治疗后ADC值及NAA/Cr比值显著升高（P = 0.006，P = 0.008），而Cho/Cr比值无显著变化（P > 0.05）。在DWI低信号组，治疗后NAA/Cr比值显著升高（P = 0.015），而ADC值及Cho/Cr比值无显著变化（P > 0.05）。