通过质子磁共振波谱检测人类免疫缺陷病毒相关脑病中的脑代谢改变。短回波时间序列与长回波时间序列的比较。

Cerebral metabolic alterations in human immunodeficiency virus-related encephalopathy detected by proton magnetic resonance spectroscopy. Comparison between sequences using short and long echo times.

作者信息

Salvan A M, Vion-Dury J, Confort-Gouny S, Nicoli F, Lamoureux S, Cozzone P J

机构信息

Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Marseille, France.

出版信息

Invest Radiol. 1997 Aug;32(8):485-95. doi: 10.1097/00004424-199708000-00008.

DOI:10.1097/00004424-199708000-00008

PMID:9258737

Abstract

RATIONALE AND OBJECTIVES

The aim of this study is to evaluate comparatively the metabolic information afforded by proton magnetic resonance (MR) spectroscopy with stimulated-echo acquisition mode (STEAM) (echo time [TE], 20 mseconds) and point-resolved spectroscopy sequence (PRESS) (TE, 135 mseconds) spectra in HIV-related encephalopathy.

METHODS

Sixty-three human immunodeficiency virus (HIV) patients and 8 controls were examined by single-voxel proton MR spectroscopy at 1.5 tesla, using both PRESS (TE, 135 mseconds) and STEAM (TE, 20 mseconds) sequences performed during the same MR examination, in the same volume of interest. Cerebral atrophy was quantitated using bicaudate ratio (BCR) and bifrontal ratio (BFR).

RESULTS

With the STEAM (TE, 20 mseconds) spectra, mean N-acetylaspartate (NAA)/choline (Cho) and NAA/creatine and phosphocreatine (Cr-PCr) ratios are reduced in acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) patients but not in neuroasymptomatics. The proportion of inositol signal is increased, that of NAA decreased in ADC patients. NAA/Cho and NAA/ Cr-PCr mean values measured with PRESS (TE, 135 mseconds) spectra are significantly reduced in ADC and neuroasymptomatic patients. Bifrontal ratio only correlates with NAA/Cr-PCr and NAA/Cho measured on the PRESS spectrum. PRESS (TE, 135 mseconds) spectra allow a definition of different metabolic patterns in HIV-related encephalopathy. At last, no correlation has been found between the NAA raw signals measured on the PRESS (TE, 135 mseconds) and STEAM (TE, 20 mseconds) spectra obtained in the same MR examination.

CONCLUSIONS

STEAM (TE, 20 mseconds) spectra provide more metabolic information-namely an evaluation of glial-neuronal status-than PRESS (TE, 135 mseconds) spectra, which afford a metabolic classification of the HIV-related encephalopathy. Because both sequences afford a similar diagnostic gain, MR spectroscopy examination probably requires spectrum acquisition with both sequences.

摘要

原理与目的

本研究旨在比较质子磁共振（MR）波谱中刺激回波采集模式（STEAM）（回波时间[TE]，20毫秒）和点分辨波谱序列（PRESS）（TE，135毫秒）光谱在HIV相关脑病中提供的代谢信息。

方法

63例人类免疫缺陷病毒（HIV）患者和8例对照在1.5特斯拉下通过单体素质子MR波谱进行检查，在同一MR检查期间，在相同的感兴趣体积中使用PRESS（TE，135毫秒）和STEAM（TE，20毫秒）序列。使用双侧尾状核比率（BCR）和双侧额叶比率（BFR）对脑萎缩进行定量。

结果

对于STEAM（TE，20毫秒）光谱，获得性免疫缺陷综合征（AIDS）痴呆综合征（ADC）患者的平均N-乙酰天门冬氨酸（NAA）/胆碱（Cho）以及NAA/肌酸和磷酸肌酸（Cr-PCr）比率降低，但神经无症状患者未降低。ADC患者中肌醇信号比例增加，NAA比例降低。用PRESS（TE，135毫秒）光谱测量的ADC和神经无症状患者的NAA/Cho和NAA/Cr-PCr平均值显著降低。双侧额叶比率仅与PRESS光谱上测量的NAA/Cr-PCr和NAA/Cho相关。PRESS（TE，135毫秒）光谱可定义HIV相关脑病中的不同代谢模式。最后，在同一MR检查中获得的PRESS（TE，135毫秒）和STEAM（TE，20毫秒）光谱上测量的NAA原始信号之间未发现相关性。