The Application Of Magnetic Resonance Spectroscopy In The Centrum Semiovale Of The Patients With Small Vessel Disease

Objective Cerebral small vessel disease(SVD) patients were collected with conventional magnetic resonance imaging(MRI) and magnetic resonance spectroscopy(MRS) in the region of interest(ROI). The quantitative measurements of NAA, Cr, Cho and the ratio among them to explore the the new diagnostic criterion of cerebral SVD.Methods Twelve cerebral SVD patients in Handan Central Hospital from 2013 to 2014 were collected, in which there were 7 males and 5 females, aged between 51-78 years old.Six healthy control subjects were selected, in which there were 3 males and females respectively, aged between 50-75 years old. In the control group, there were no the manifestation of infaction and leukoaraiosis(LA) in the MRI, as well as other severe diseases. All of the subjects underwent the baseline assessment and conventional MRI.After divided the ROI of central semiovale(CS), the multiple-voxels MRS were undergone in subjects, the data was post-processed with GE AW4.2 software, and the concentration of NAA, Cr, Cho were quantitatively determination. After calculating the ratio among the three metabolites, pairwise comparision was conducted. The MRS were repeated again for the SVD patients after 1 month and 3 month clinical therapeutic intervention, and the ratio among the three metabolites were calculated respectively. The results were statistical analysised with SPSS13.0. The differences between different groups were analyzed the t test and Wilcoxon rank sum test.Results 1 LA was showed in the CS region of conventional MRI in several cerebral SVD patients(3 males and 2 females). There was lacunar infaction in some patients suffering of cerebral SVD(5 males and 3 females). There was no lacunar infaction or LA was observed in the healthy contral subjects. 2 Comparing the MRS parameter in the ROI,the ratio of NAA/Cho and NAA/Cr were obviously lower in cerebral SVD group than that of control group(P<0.01); whereas the ratio of Cho/Cr was no statisticly difference between the groups or sides. 3 After 1 month and 3 month clinical therapeutic intervention,Conclusion 1 The application of multiple-voxel MRS scan of CS can quantatively detect the changes of NAA, Cr, Cho level in brain white matter. The ratio of NAA/Cho and NAA/Cr are obviously lower in cerebral SVD patients than that of control group, suggesting the ratio of NAA/Cho and NAA/Cr can be used as an important tool in the diagnosis and differential diagnosis of cerebral SVD patients. 2 With the improvement of symptoms after treatment, the ratio of NAA/Cr and NAA/Cho can be elvated in the cerebral SVD patients, suggesting the MRS index also be useful in the evaluation of the therapeutic effect of cerebral SVD.