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定量 1H-MRS 揭示皮质发育畸形亚类之间的代谢差异。

Quantitative 1H-MRS reveals metabolic difference between subcategories of malformations of cortical development.

机构信息

Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.

Department of Radiotherapy, West China Hospital of Sichuan University, Chengdu, 610041, China.

出版信息

Neuroradiology. 2021 Sep;63(9):1539-1548. doi: 10.1007/s00234-021-02694-y. Epub 2021 Mar 23.

Abstract

PURPOSE

To figure out the spectra features of malformations of cortical development (MCDs) and the differences between MCDs subcategories.

METHODS

Twenty patients and 18 controls were studied. The patients included two subcategories: disorders of migration (DOM) and postmigration (DOPM). Spectra of patients were acquired from both the lesion and the normal-appearing contralateral side (NACS), and they were compared to those of the controls obtained from the frontal lobe.

RESULTS

Compared to the controls, a decreased NAA (P = 0.002) was identified in MCDs. After dividing the MCDs into the DOM and DOPM, we found that NAA reduction was only notable in the DOM (P = 0.007). Moreover, Ins and Cr of the DOPM were higher than those of the controls (P = 0.017 and 0.013) and the DOM (P = 0.027 and 0.001). Compared to the NACS, a decreased NAA (P = 0.042) and an increased Ins (P = 0.039) were identified in the lesion of MCDs. After dividing the MCDs into the DOM and DOPM, we found no significant differences in the DOM, but Ins, Cr, and Glx of the lesion were higher than those of the NACS (P = 0.007, 0.005 and 0.047) in the DOPM. In addition, we found that Cr and Glx correlated positively to the seizure frequency (P = 0.003 and 0.016).

CONCLUSION

Decreased NAA was the prominent abnormality confirmed in MCDs. Spectra of different MCDs subcategories were different: the DOM was characterized by decreased NAA, while the DOPM was characterized by increased Ins.

摘要

目的

探讨皮质发育畸形(MCD)的频谱特征及其各亚型之间的差异。

方法

共纳入 20 例患者和 18 例对照。患者分为移行障碍(DOM)和移行后障碍(DOPM)两类。于病灶区和对侧正常区(NACS)采集患者频谱,与对照组(额叶)频谱进行对比。

结果

与对照组相比,MCD 组 NAA 降低(P=0.002)。将 MCD 分为 DOM 和 DOPM 后发现,仅 DOM 组 NAA 降低具有统计学意义(P=0.007)。此外,DOPM 组 Ins 和 Cr 高于对照组和 DOM 组(P=0.017 和 0.013,P=0.027 和 0.001)。与 NACS 相比,MCD 病灶区 NAA 降低(P=0.042),Ins 升高(P=0.039)。将 MCD 分为 DOM 和 DOPM 后发现,DOM 组各代谢物未见显著差异,而 DOPM 组病灶区 Ins、Cr 和 Glx 高于 NACS(P=0.007、0.005 和 0.047)。此外,我们发现 Cr 和 Glx 与癫痫发作频率呈正相关(P=0.003 和 0.016)。

结论

NAA 降低是 MCD 的主要异常表现。不同 MCD 亚型的频谱特征不同:DOM 以 NAA 降低为特征,而 DOPM 以 Ins 升高为特征。

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