Abstract: Objective To study the brain biochemical metabolism changes of infantile spasms through hydrogen proton magnetic resonance spectroscopy(¹HMRS). Methods A total of 40 cases of infantile spasms and 10 age-matched normal infants were performed brain 1.5T MRI and multi-voxel ¹H-MRS exminations, volume of interest (VOI) included thalamus, basal ganglia, temporal lobe, the signal intensities of N-acetylaspartate(NAA), creatine+phosphocreatine (Cr), choline-containig compounds(Cho) were obtained, the ratios of NAA/Cho+Cr, Cho/Cr, and NAA/Cr were set into comparison bilaterally between the patients and controls. Results 1)The ratios of NAA/Cho+Cr, NAA/Cho, NAA/Cr were lower than normal group(P＜0.01), and the ratios of Cho/Cr were increased than normal group, the difference were statistically significant(P all ＜0.01).2)High lac peak could be seen in areas of lesions often. Conclusion The ¹H-MRS can noninvasively evaluate changes of cerebral metabolism in infantile spasms.

Key words: infantile spasms, hydrogen proton magnetic resonance spectroscopy, volume of interest, biochemical metabolism

摘要： 目的 通过氢质子磁共振波谱分析(¹H-MRS)探讨婴儿痉挛症患儿脑内生化代谢的改变, 为临床诊治提供依据。方法 利用1.5T超导MRI扫描仪对住院的40例婴儿痉挛症患儿与10例同龄正常的婴幼儿颅脑行MRI平扫和¹HMRS检查, 选取相同感兴趣区:双侧丘脑、基底节区、颞叶, 获得脑组织的波谱曲线图及N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)的相对浓度。结果 1)病例组中基底节区、丘脑区、颞叶NAA/Cho+Cr、NAA/Cho 、NAA/Cr比值较对照组下降, Cho/Cr比值较对照组升高, 差异有统计学意义(P<0.01);2)病灶区域常可见高大乳酸峰。结论 ¹H-MRS能无创性评估婴儿痉挛症患儿脑内生化代谢的变化。

关键词: 婴儿痉挛症, 氢质子磁共振波谱成像, 感兴趣区, 生化代谢