Song Zhijun, Chen Xiaolei, Tang Yunlin, Tang Boheng, Zeng Ting, Sun Zhenghui, Yu Xinguang, Zhou Dingbiao
Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China.
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Zhonghua Yi Xue Za Zhi. 2014 Jul 1;94(25):1925-8.
To evaluate the diagnostic value of magnetic resonance spectroscopy (MRS) and the role of intraoperative magnetic resonance imaging (iMRI) in the treatment of brain abscesses by aspiration and drainage.
From November 2009 to June 2013, Forty-one brain abscess patients were evaluated. MRS was employed to acquire the metabolic information and assist in the differential diagnosis of brain abscesses showing lactate cytosolic amino acids (AAs) with/without succinate, acetate, alanine and glycine on MRS. Diffusion-weighted imaging (DWI) was also helpful. Eleven single deep-seated abscesses underwent aspiration and drainage with 1.5 T iMRI and neuronavigation system.
Forty-one brain abscesses were all diagnosed correctly. Ten single deep-seated abscesses underwent aspiration and drainage with 1.5 T iMRI and neuronavigation system successfully with just one puncture. One deep-seated abscess with thick-walled was punctured thrice before achieving success because of aspirated needle sidesliping. All 11 deep-seated abscess cases were cured and were also confirmed by follow-up. None of them suffered from significant complications, such as intracranial bleeding or new neurological deficit.
MRS may acquire the metabolic information, confirm the presence of AAs with/without succinate, acetate, alanine and glycine and assist in the differential diagnosis of brain abscesses. iMRI system can help detect aspirated needle sidesliping and correct it in time to improve the cure rate, especially for single deep-seated brain abscess with a thick wall.
评估磁共振波谱（MRS）的诊断价值以及术中磁共振成像（iMRI）在脑脓肿穿刺引流治疗中的作用。
对2009年11月至2013年6月期间的41例脑脓肿患者进行评估。采用MRS获取代谢信息，辅助诊断脑脓肿，观察MRS上是否存在乳酸、胞质氨基酸（AAs）以及有无琥珀酸、乙酸、丙氨酸和甘氨酸。扩散加权成像（DWI）也有帮助。11例单发深部脓肿患者在1.5T iMRI和神经导航系统辅助下进行穿刺引流。
41例脑脓肿均被正确诊断。10例单发深部脓肿在1.5T iMRI和神经导航系统辅助下一次穿刺成功进行了引流。1例厚壁深部脓肿因穿刺针侧滑，穿刺3次才成功。11例深部脓肿患者均治愈，随访也证实了这一点。无一例出现严重并发症，如颅内出血或新的神经功能缺损。
MRS可获取代谢信息，确认有无琥珀酸、乙酸、丙氨酸和甘氨酸等氨基酸的存在，辅助脑脓肿的鉴别诊断。iMRI系统有助于检测穿刺针侧滑并及时纠正，提高治愈率，尤其对于单发厚壁深部脑脓肿。
