Tzika A A, Ball W S, Vigneron D B, Dunn R S, Nelson S J, Kirks D R
Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio.
Radiology. 1993 Nov;189(2):467-80. doi: 10.1148/radiology.189.2.8210375.
Image-guided, single-voxel, localized proton magnetic resonance (MR) spectroscopy was performed to assess white matter in childhood adrenoleukodystrophy (ALD).
Eleven X-linked ALD subjects, seven with neurologic symptoms or white matter lesions at MR imaging and four asymptomatic patients, were compared with nine aged-matched, healthy volunteers.
Compared with those from normal white matter, MR spectra from white matter lesions (n = 6) showed 65% reduction in the ratio of N-acetyl aspartate (NAA) to total creatine (tCr) (P < .01); 55% increase in the ratio of choline-containing compounds (Cho) to tCr (P < .02); substantial levels of tCr; 94% increase in the ratio of glutamate, glutamine, or inositol to tCr (P < .02); and lactate accumulation in four patients. Patients without brain lesions (n = 4) exhibited a 51% increase in Cho-to-tCr ratio (P < .01) and 11% nonsignificant increase in NAA-to-tCr ratio.
Proton MR spectroscopy may prove a valuable technique for noninvasive diagnostic and prognostic assessment of ALD.
采用影像引导下的单体素局部质子磁共振（MR）波谱分析来评估儿童肾上腺脑白质营养不良（ALD）中的白质情况。
将11名X连锁ALD患者（7名在MR成像时有神经系统症状或白质病变，4名无症状患者）与9名年龄匹配的健康志愿者进行比较。
与正常白质的MR波谱相比，白质病变区域（n = 6）的波谱显示N - 乙酰天门冬氨酸（NAA）与总肌酸（tCr）的比值降低了65%（P <.01）；含胆碱化合物（Cho）与tCr的比值增加了55%（P <.02）；tCr水平较高；谷氨酸、谷氨酰胺或肌醇与tCr的比值增加了94%（P <.02）；4名患者有乳酸蓄积。无脑病变的患者（n = 4）显示Cho与tCr的比值增加了51%（P <.01），NAA与tCr的比值有11%的增加但无统计学意义。
质子MR波谱分析可能是一种用于ALD无创诊断和预后评估的有价值技术。
