Dev R, Gupta R K, Poptani H, Roy R, Sharma S, Husain M
Department of Neurosurgery, King George Medical College, Lucknow, Uttar Pradesh, India.
Neurosurgery. 1998 Jan;42(1):37-42; discussion 42-3. doi: 10.1097/00006123-199801000-00008.
In vivo proton magnetic resonance spectroscopy was performed for 24 patients with pyogenic brain abscesses, to examine the consistency of the spectral patterns and to observe the changes in metabolites with treatment.
Localized proton spectra were obtained from 4- to 8-ml volumes in the abscesses, using stimulated echo acquisition mode and spin echo sequences. Twenty-two patients were treated with combined surgical and medical therapy, and two patients were treated conservatively. High-resolution magnetic resonance spectroscopy was performed for 15 samples of abscesses obtained from these patients, to confirm the assignments of resonances seen in vivo. Postaspiration studies were performed for 12 patients treated with combined medical and surgical therapy and 2 patients treated medically.
Lactate and amino acids were seen in spectra for all patients, irrespective of the time of spectroscopy after the onset of combined medical and surgical therapy. Acetate and pyruvate disappeared after 1 week of combined treatment.
It was concluded that spectral patterns for brain abscesses are consistent and specific and can assist in the noninvasive diagnosis of abscesses. Responses to combined treatment could be monitored by showing the changes in metabolite patterns in serial spectroscopic studies.
对24例化脓性脑脓肿患者进行体内质子磁共振波谱分析，以检查光谱模式的一致性，并观察治疗过程中代谢物的变化。
采用刺激回波采集模式和自旋回波序列，从脓肿中4至8毫升的体积中获取局部质子谱。22例患者接受了手术和药物联合治疗，2例患者接受了保守治疗。对从这些患者身上获取的15个脓肿样本进行了高分辨率磁共振波谱分析，以确认体内所见共振的归属。对12例接受手术和药物联合治疗的患者以及2例接受药物治疗的患者进行了穿刺后研究。
所有患者的光谱中均可见乳酸和氨基酸，与手术和药物联合治疗开始后的光谱检查时间无关。联合治疗1周后，醋酸盐和丙酮酸盐消失。
得出结论，脑脓肿的光谱模式是一致且特异的，可有助于脓肿的无创诊断。通过在系列光谱研究中显示代谢物模式的变化，可以监测对联合治疗的反应。
