The Preliminary Study Of Proton Magnetic Resonance Spectroscopy(~1H-MRS) And Diffusion Tensor Imaging (DTI)in The Subcortical Arteriosclerotic Encephalopathy

Objective To investigate the imaging features and practice value of proton magnetic resonance spectroscopy (1H-MRS) combined with diffusion tensor imaging(DTI) in subcortical arteriosclerotic encephalopathy(SAE/BD), so as to improve our powers of understanding of BD and provide more and valuer information for early and accurate diagnosis of this disease.Methods Routine MRI and2D1H-MRS、DTI were performed in40cases(patients who had been diagnosed with BD through clinical and imaging examination) and40healthy elderly (who were matched in the age, without obvious symptoms and cerebrovascular disease history) as a control group. NAA/Cr, Cho/Cr ratio, ADC and FA were calculated and analyzed statistically in the lesions of BD (lesions in white matter areas beside frontal horn、central part and occipital horn of both sides of lateral ventricle), normal-white matter areas of BD and normal white matter areas of the control group, and the change of NAA, CHO, Cr and Lac peaks were analyzed.Results1.1H-MRS:NAA and CHO leaks decreased obviously in BD lesions,and obvious, inverted Lac double-peak appeared. NAA/Cr, CHo/Cr decreased in BD lesions and there was a significant difference between BD lesions and the control group compared with the control group(P<0.05). NAA and CHO leaks decreased in normal white matters of BD.and inverted Lac double-peak appeared. NAA/Cr decreased significantly in normal white matters of BD(P<0.05) while there was not a significant difference between BD lesions and the control group (P>0.05). The hight of peaks of NAA, CHO, Cr and Lac is normal in control group, and values of NAA/Cr, and Cho/Cr were also normal. Lac peak appeared in all lesions of BD and25cases of normal white matter of BD.NAA/Cr decreased in lesions in white matter areas beside frontal horn and occipital horn compared with central part of both sides of lateral ventricle and there was a significant difference between them (P<0.05), while there was no significant difference in CHo/Cr among them (P>0.05)2. DTI:FA decreased and ADC increased obviously in BD lesions compared with the control group and there was a significant difference among them (P<0.05).FA decreased and ADC increased in normal white matter of BD compared with the control group and there was a significant difference among them (P<0.05).FA decreased and ADC increased in lesions in white matter areas beside frontal horn and occipital horn compared with central part of both sides of lateral ventricle and there was a significant difference between them(P<0.05).FA of corpus callosum increased significantly compared with white matter areas beside frontal horn、central part and occipital horn of both sides of lateral ventricle (P<0.05).3. NAA/Cr was negatively correlated to ADC and positively correlated to FA in BD lesions and normal-white matter areas of BD, but the difference degree was more obvious in the former than the latter. ADC was was negatively correlated to FA in all the regions of interest in the3group.Conclusion1H-MRS combined with DTI could provide potentially useful information about the metabolic characteristics and pathomechanism of BD, and it provide comprehensive information about the diagnosis and prognostic value of BD.The finding of microstructural and microscopical metabolic white matter changes which are normally seen with conventional MRI provide the possibility of prospective study about BD.