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目的:应用质子磁共振波谱(1H-MRS)技术研究急性脑梗死梗死灶体积大小对患侧半卵圆中心代谢的影响。方法:应用1.5T MRI扫描仪对28例临床和MRI确诊为大脑中动脉支配区急性(6~48 h)脑梗死患者(病例组)、同期收治的半卵圆中心脑梗死患者10例(阳性对照组)和健康志愿者20名(正常对照组)均进行1H-MRS检测,测量患侧及健侧半卵圆中心感兴趣区(ROI)的N-乙酰天冬氨酸(NAA)/肌酸(Cr)比值、胆碱化合物(Cho)/肌酸(Cr)比值,所用序列为点解析波谱序列。采用Efilm workstation影像软件处理MRI,测量并计算梗死灶体积。根据脑梗死灶体积大小再将病例组分为0.5~7.9cm3、8~15.9 cm3和16~24 cm3亚组,采用SPSS 11.0统计软件行单因素方差分析。结果:①病例组(双侧)、正常对照组和阳性对照组半卵圆中心ROI:NAA/Cr、Cho/Cr比值均差异有统计学意义(P<0.05);②患侧ROI:0.5~7.9 cm3亚组NAA/Cr、Cho/Cr比值均较8~15.9 cm3组和16~24 cm3亚组高,组间比较差异均有统计学意义(P<0.05);16~24 cm3亚组NAA/Cr、Cho/Cr比值均较0.5~7.9 cm3亚组和8~15.9 cm3亚组低,组间比较均差异有统计学意义(P<0.05)。结论:梗死灶体积为0.5~24 cm3时,病例组患侧半卵圆中心ROI损伤随梗死灶面积增大而加重;其中16~24 cm3亚组半卵圆中心ROI的损伤最为严重。
OBJECTIVE: To study the effect of infarct size on the hemisphere center metabolism in patients with acute cerebral infarction by proton magnetic resonance spectroscopy (1H-MRS). Methods: A total of 28 patients with acute cerebral infarction (6-48 h) cerebral infarction (case group) and 10 patients with semi-oval central cerebral infarction (positive (Control group) and healthy volunteers (normal control group) were detected by 1H-MRS to measure the N-acetyl-aspartate (NAA) / muscle Acid (Cr) ratio, choline compound (Cho) / creatine (Cr) ratio, the sequence used for point analysis of spectral sequences. MRI was performed using Efilm workstation imaging software to measure and calculate infarct volume. According to the size of cerebral infarction volume, the cases were divided into 0.5 ~ 7.9cm3, 8 ~ 15.9cm3 and 16 ~ 24cm3 subgroups. SPSS 11.0 statistical software was used to perform one-way ANOVA. Results: ①The ROI: NAA / Cr and Cho / Cr ratios of the semiovale in the case group (bilateral), normal control group and positive control group were significantly different (P <0.05); ② The ipsilateral ROI was 0.5 ~ The ratios of NAA / Cr and Cho / Cr in 7.9 cm3 subgroup were higher than those in 8-15.9 cm3 subgroup and 16-24 cm3 subgroup, with statistical significance (P <0.05) / Cr, Cho / Cr ratio were lower than the 0.5 ~ 7.9 cm3 subgroup and 8 ~ 15.9 cm3 subgroup, the difference between the two groups was statistically significant (P <0.05). CONCLUSION: When infarct size is 0.5-24 cm3, the ROI of the hemisphere at the affected side of the patient group aggravates with the increase of the area of the infarct. The ROI of the semio-oval center in the 16-24 cm3 subgroup is the most serious.