Chang L, Miller B L, McBride D, Cornford M, Oropilla G, Buchthal S, Chiang F, Aronow H, Beck C K, Ernst T
Department of Neurology, Harbor-University of California Los Angeles Medical Center, University of California Los Angeles School of Medicine, Torrance 90509, USA.
Radiology. 1995 Nov;197(2):525-31. doi: 10.1148/radiology.197.2.7480706.
To evaluate the role of proton (hydrogen-1) magnetic resonance (MR) spectroscopy in the differential diagnosis of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS).
Twenty-six men with 35 AIDS-related brain lesions underwent MR imaging and localized H-1 MR spectroscopy. Lesions consisted of 11 toxoplasmic abscesses, 12 progressive multifocal leukoencephalopathic lesions, eight lymphomas, and four cryptococcomas. Metabolite peak areas in the lesions were compared with those in the contralateral hemisphere in each patient.
H-1 MR spectroscopic findings showed significantly different biochemical profiles for each diagnostic group (P = .0001) with regard to N-acetyl compounds, total creatine pool, choline-containing compounds, myoinositol, and lactate. H-1 MR spectroscopy alone helped correctly diagnose 94% (84% with jackknifed classification) of the brain lesions, without overlap between toxoplasmosis and lymphoma.
H-1 MR spectroscopy is a sensitive and potentially specific noninvasive adjunctive method for differential diagnosis of focal brain lesions in AIDS.
评估质子（氢-1）磁共振波谱在获得性免疫缺陷综合征（AIDS）患者局灶性脑病变鉴别诊断中的作用。
26名患有35处与AIDS相关脑病变的男性患者接受了磁共振成像和局部氢-1磁共振波谱检查。病变包括11处弓形虫脓肿、12处进行性多灶性白质脑病病变、8处淋巴瘤和4处隐球菌瘤。将每位患者病变中的代谢物峰面积与其对侧半球的峰面积进行比较。
氢-1磁共振波谱结果显示，就N-乙酰化合物、总肌酸池、含胆碱化合物、肌醇和乳酸而言，每个诊断组的生化谱有显著差异（P = .0001）。仅氢-1磁共振波谱就有助于正确诊断94%（刀切法分类为84%）的脑病变，弓形虫病和淋巴瘤之间无重叠。
氢-1磁共振波谱是一种敏感且可能具有特异性的非侵入性辅助方法，用于AIDS患者局灶性脑病变的鉴别诊断。
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