南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (03): 352-354.

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~1H-MRS在蛛网膜下腔出血性脑血管痉挛发生时的评价作用

全伟； 李铁林； 陈光忠； 姜晓丹； 徐如祥； 柯以铨； 段传志； 吕建平； 张昊； 谢伟； 钟文军； 陈颖东； 陈凡帆；   

  1. 南方医科大学珠江医院神经外科； 广州市第一人民医院神经外科； 广州市第一人民医院神经外科 广东广州510282； 广东广州510180； 广东广州510282；
  • 出版日期:2006-03-20 发布日期:2006-03-20

Evaluation of cerebral vasospasm resulting from subarachnoid hemorrhage with ~1H-magnetic resonance spectroscopy

QUAN Wei1,2,LI Tie-lin1,CHEN Guang-zhong1,JIANG Xiao-dan1,XU Ru-xiang1,KE Yi-quan1,DUAN Chuan-zhi1,L Jian-ping2,ZHANG Hao2,XIE Wei2,ZHONG Wen-jun2,CHEN Ying-dong2,CHEN Fan-fan21Department of Neurosurgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;2Department of Neurosurgery,First Municipal People’s Hospital of Guangzhou,Guangzhou 510180,China   

  1. 南方医科大学珠江医院神经外科； 广州市第一人民医院神经外科； 广州市第一人民医院神经外科 广东广州510282； 广东广州510180； 广东广州510282；
  • Online:2006-03-20 Published:2006-03-20

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摘要： 目的探讨活体质子磁共振波谱(1H-MRS)在蛛网膜下腔出血(SAH)性脑血管痉挛发生时的评价作用。方法采用两次注血法建立狗SAH模型,实验分为注射生理盐水组和注血组。于模型制作成功后3、7、14d分别进行1H-MRS检查扫描,记录胆碱(Cho)、N-乙酰基天冬氨酸(NAA)和肌酸(Cr)的变化。1H-MRS扫描后即刻进行脑血管造影检查,测定基底动脉血管痉挛发生情况,与1H-MRS扫描结果加以比较分析。结果脑血管造影结果提示在第3天基底动脉血管发生明显痉挛,到第7天各段血管痉挛最为显著,第14天血管痉挛明显改善;1H-MRS的检测指标显示注血组各项指标在第3、7天变化较大,其中NAA在第3天下降到低谷,之后逐渐回升,至第14天接近正常水平;Cho在第3天稍有下降,然后上升,至第7天上升至高峰,尔后下降;而Cr则一直表现为上升趋势,但第7天后上升趋势明显放缓,与第14天相对含量相比差异无显著性(P>0.05)。1H-MRS功能检测结果与脑血管造影结果具有一定的吻合性。结论1H-MRS可用来监测蛛网膜下腔出血性脑血管痉挛发生时病程进展,是一种较好的功能影像学评价手段。 更多还原

Abstract: Objective To assess the value of 1H-magnetic resonance spectroscopy(1H-MRS) in evaluating cerebral vasospasm resulting from subarachnoid hemorrhage(SAH).Methods Six dogs were subjected to autologous non-heparinized blood injection via cisternal puncture twice at one-day interval to establish models of SAH,and another 6 received injections with normal saline in an identical manner.1H-MRS scan was performed on the 3rd,7th and 14th days after the injections to measure the changes of N-acetylaspartate(NAA),creatine(Cr) and choline(Cho).After the 1H-MRS scan,all the dogs underwent brain digital subtraction angiography(DSA) for determining the basilar artery diameter.Results DSA results on day 3 presented development of obvious vasospasm of the basilar artery,which was most evident on day 7 and recovered obviously on day 14.1H-MRS results demonstrated obvious changes of NAA,Cho and Cr on days 3 and 7 in SAH model group,and NAA declined to the lowest level on day 3 followed by gradual ascending till reaching the normal level on day 14.Cho decreased slightly on day 3,then increased and reached the peak level on day 7 and then decreased.Cr rose steadily from day 3 to 14,but since day 7,the rise slowed down obviously and Cr maintain a level not significantly different from that on day 14(P>0.05).The functional results of 1H-MRS were consistent with the DSA results.Conclusion 1H-MRS can be used to monitor the development of cerebral vasospasm resulting from SAH as a good evaluation method for functional imaging.

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