【摘要】 目的应用氢质子磁共振波谱(1H-MRS)检测热性惊厥(FS)患儿脑组织生化代谢物,了解FS发作后脑损伤情况,探讨1H-MRS在FS中应用的意义。方法对25例FS患儿和6例神经系统正常儿童进行常规头颅MRI和颞叶海马区的1H-MRS检查。25例FS患儿中,15例为单纯性热性惊厥(SFS),10例为复杂性热性惊厥(CFS)。检测指标为N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、谷氨酸-谷氨酰胺复合物(Glx)和乳酸(Lac)的信号强度,计算并比较NAA/(Cho+Cr)和Lac/Cr的比值。结果头颅MRI检查结果为FS组及对照组均未显示异常。1H-MRS检测结果为NAA/(Cho+Cr)比值,SFS组为0.71±0.05,CFS组为0.65±0.04,对照组为0.73±0.05,CFS组明显低于SFS组及对照组(Pa<0.01),但后二者之间无明显差异(P>0.05)。Lac/Cr比值SFS组(0.32±0.21)和CFS组(0.63±0.30)高于对照组(0.05±0.04)(Pa<0.05),且CFS组高于SFS组(P<0.01)。结论1H-MRS作为一项无创检查,能更敏感地发现FS患儿的早期脑损伤,为FS尤其是CFS患儿的治疗、评估预后提供客观依据。更多还原

【Abstract】 Objective To investigate the application of proton magnetic resonance spectroscopy (1H-MRS) in detecting the biochemical metabolism in children with febrile seizure(FS), and to evaluate the information of brain injury and study the clinical significance of 1H-MRS in FS.Methods Twenty-five cases of children with FS [15 cases with simple febrile seizure(SFS) and 10 cases with complex (CFS)] and 6 cases without nervous system disease exprienced magnetic resonance imaging(MRI) examinations of skull and single-voxel 1H-MRS examinations of the hippocampi-temporal lobe. The signal intensities of N-acetylaspartate(NAA),eatine+phosphocreatine(Cr),choline-containig compounds(Cho),lactate(Lac)and the ratios of NAA/(Cho+Cr) and Lac/Cr were set into comparison between the patients and controls.Results The study showed that all children investigated by MRI were normal. The ratio of NAA/(Cho+Cr) in SFS patients was 0.71±0.05,CFS patients was 0.65±0.04,control group was 0.73±0.05. The NAA/(Cho + Cr) ratio in CFS group was lower than that in SFS and control group (Pa<0.01), but no significant difference was found between SFS and control groups (P>0.05).The ratios of Lac/Cr in the patients of SFS group(0.32±0.21) and CFS group (0.65±0.30) were higher than that in control group(0.05±0.04) (Pa<0.05), and Lac/Cr ratio in patients of CFS group was higher than that in SFS group(P<0.01).Conclusion 1H-MRS can provide earlier information on brain injury sensitively and noninvasively in children with FS, and it may be used for therapy and prognosis in children with FS,especially CFS.更多还原