CEREBRAL METABOLITE PATTERNS IN DIALYSIS PATIENTS - EVALUATION WITH H-1 MR SPECTROSCOPY
CEREBRAL METABOLITE PATTERNS IN DIALYSIS PATIENTS - EVALUATION WITH H-1 MR SPECTROSCOPY
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DOI：
10.1148/radiology.194.3.7862964
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发表时间：
1995-03-01
期刊：
影响因子：
19.7
通讯作者：
FEUERBACH, S
中科院分区：
文献类型：
--
作者：
GEISSLER, A;FRUND, R;FEUERBACH, S
目的：分析透析患者脑代谢变化。材料与方法：对16例血液透析患者，10例连续动态腹膜透析（CAPD）患者和42名健康志愿者进行磁共振（MR）波谱和磁共振成像。从一个枕部灰质体素和一个顶叶白质体素中获得光谱。分析n -乙酰天冬氨酸（NAA）、胆碱（Cho）、肌醇和甘氨酸（Myo）、肌酸（Cr）的变化，并以比值表示，以Cr为参比。结果：在血液透析患者的频谱中观察到三种异常：(a)灰质Cho/Cr比值显著升高，(b)灰质Myo/Cr比值显著升高，(c)灰质和白质NAA/Cr比值显著降低。在皮质灰质中发现最强的代谢改变。在CAPD患者中，只有灰质Cho/Cr比值显著升高。在透析患者的MR图像上观察到局灶性白质病变的频率增加。结论：质子磁共振光谱可用于体内监测慢性透析引起的脑代谢变化。
PURPOSE: To analyze metabolic changes in the brain of patients undergoing dialysis.MATERIALS AND METHODS: Sixteen patients undergoing hemodialysis, 10 patients undergoing continuous ambulatory peritoneal dialysis (CAPD), and 42 healthy volunteers underwent magnetic resonance (MR) spectroscopy and MR imaging. Spectra were obtained from one occipital gray matter voxel and one parietal white matter voxel. Changes in N-acetylaspartate (NAA), choline (Cho), myo-inositol and glycine (Myo), and creatine (Cr) were analyzed and the results presented as ratios, with Cr as the reference.RESULTS: Three abnormalities were observed in the spectra of the hemodialysis patients: (a) significant elevation of the Cho/Cr ratio in gray matter, (b) significant elevation of the Myo/Cr ratio in gray matter, and (c) significant reduction of the NAA/Cr ratio in gray and white matter. The strongest metabolic alterations were found in cortical gray matter. In CAPD patients, only gray matter Cho/Cr ratio was significantly elevated. An increased frequency of focal white matter lesions was observed on MR images in the dialysis patients.CONCLUSION: Proton MR spectroscopy is useful for in vivo monitoring of metabolic alterations in the brain due to chronic dialysis.