Confort-Gouny S, Vion-Dury J, Nicoli F, Dano P, Donnet A, Grazziani N, Gastaut J L, Grisoli F, Cozzone P J
Centre de Résonance Magnétique Biologique et Médicale, URA-CNRS 1186, Faculté de Médecine, Marseille, France.
J Neurol Sci. 1993 Sep;118(2):123-33. doi: 10.1016/0022-510x(93)90101-4.
We conducted an extended clinical evaluation of localized proton magnetic resonance spectroscopy (MRS) of the brain, performed on various brain diseases using short stimulated echo times. Pathologies studied were mainly multiple sclerosis, stroke, leukoaraiosis, AIDS-related leukoencephalopathies and glial tumors. Other miscellaneous pathologies were also studied. Magnetic resonance examination of the brain was conducted on a Siemens Magnetom SP63 (equipped with a 1.5 T magnet). Localized proton MRS was performed on a routine basis immediately after imaging, using the STEAM (stimulated echo acquisition mode) with a short echo time (20 ms) combined with a CHESS (chemical shift selective excitation) sequence. One or two VOI (8 ml) were examined. Data on 125 spectra were processed by principal component analysis (PCA) and conventional variance analysis. The following metabolite resonances were studied: inositol-glycine, taurine-scyllo-inositol, choline derivatives, phosphocreatine-creatine, aspartate, glutamine glutamate, N-acetylaspartate, acetate and lactate. PCA demonstrates that the different metabolic variables are independent. The analysis of groups of spectra clearly demonstrates that the metabolic profiles detected by localized MRS in various pathologies (i) differ significantly from controls, and (ii) allow a metabolic discrimination between groups of pathologies. Results of PCA are confirmed by variance analysis. Strokes are characterized by an increase in lactate concentration and leukoaraiosis by a decrease in inositol-glycine resonance. AIDS-related leukodystrophies are characterized by increases in lactate and choline concentrations. Reduction in N-acetylaspartate which is observed in most pathologies is not significant in the small lesions of white matter. Lactate has often been found in MS plaques, but no variation in the choline/phosphocreatine ratio was observed. GABA was tentatively assigned in the spectrum of a patient with epilepsy under sodium valproate treatment. This study illustrates the clinical feasibility of the technique, the value of a multiparametric data analysis in the definition of the pertinent variables characterizing the metabolic impairment, and the impact of localized proton MR spectroscopy of the brain in the assessment of cerebral suffering.
我们对脑部局部质子磁共振波谱（MRS）进行了扩展临床评估，该评估使用短刺激回波时间，针对各种脑部疾病展开。所研究的病理情况主要包括多发性硬化症、中风、脑白质疏松症、艾滋病相关脑白质病以及胶质瘤。还研究了其他各类病理情况。脑部磁共振检查在西门子Magnetom SP63（配备1.5T磁体）上进行。成像后立即常规进行局部质子MRS，采用短回波时间（20ms）的STEAM（刺激回波采集模式）并结合CHESS（化学位移选择性激发）序列。检查1至2个感兴趣区（8ml）。对125个波谱的数据进行主成分分析（PCA）和传统方差分析。研究了以下代谢物共振峰：肌醇 - 甘氨酸、牛磺酸 - 异肌醇、胆碱衍生物、磷酸肌酸 - 肌酸、天冬氨酸、谷氨酰胺 - 谷氨酸、N - 乙酰天门冬氨酸、乙酸盐和乳酸盐。PCA表明不同代谢变量相互独立。对波谱组的分析清楚地表明，局部MRS在各种病理情况下检测到的代谢谱：（i）与对照组有显著差异，（ii）能够区分不同病理组的代谢情况。PCA结果经方差分析得到证实。中风的特征是乳酸浓度升高，脑白质疏松症的特征是肌醇 - 甘氨酸共振峰降低。艾滋病相关脑白质营养不良的特征是乳酸和胆碱浓度升高。在大多数病理情况下观察到的N - 乙酰天门冬氨酸减少在小的白质病变中不显著。乳酸常出现在多发性硬化症斑块中，但未观察到胆碱/磷酸肌酸比值的变化。在接受丙戊酸钠治疗的癫痫患者波谱中初步确定了γ-氨基丁酸。本研究说明了该技术的临床可行性、多参数数据分析在定义表征代谢损伤的相关变量中的价值，以及脑部局部质子磁共振波谱在评估脑部病变中的作用。
