脑泡状棘球蚴病对人脑的破坏性极强,临床表现复杂多样。尽管血清学及各种影像成像技术在脑泡状棘球蚴病的早期诊断及鉴别诊断价值得到了多数研究者的认同,但随着MR设备及新技术的不断进展和成熟,各种功能性磁共振成像(functional magnetic resonance imaging,fMRI)已达到了生物代谢及分子成像水平,对该病诊断提供重要的参考价值。本文通过对目前脑泡状棘球蚴病的fMRI成像进展予以综述,以期对脑泡状棘球蚴病的诊断进行有益提示。
Background Cerebral alveolar echinococcosis （CAE） grows infiltratively like a malignant tumor, causing great harm to the human body. It is possible to display mass lesions of CAE using various imaging systems, but regarding the infiltrating proliferation active regions, it is difficult to evaluate its actual range using conventional magnetic resonance imaging （cMRI）. This research focused on proton magnetic resonance spectroscopy （1HMRS） techniques to find the mass and infiltration zone of CAE. We explored the marginal zone （MZ） of CAE nearly close to the actual infiltrating scope, to provide reliable images for clinical purposes, to overcome shortcomings of cMRI, to formulate beneficial clinical surgical plans and assess prognosis. Methods Between September 2005 and May 2011, 15 patients who were suffering from CAE （36 effective lesions altogether） were examined by 1HMRS at the first affiliated hospital of Xinjiang Medical University. Multi-voxel 1HMRS was acquired with a 1.5T MRI scanner. Concentrations and the ratios of the metabolites of CAE were calculated. Furthermore, changes in the concentrations of the metabolites containing N-acetyl-aspartic-acid （NAA）, choline （Cho）, creatine （Cr）, lipids and lactate （Lip＋Lac） and the ratios of Cho/Cr, NAA/Cr, （Lip＋Lac）/Cr were compared in the substantial region, 0-10 rnm MZ, and 11-20 mm MZ of the infiltration zone, as well as the corresponding contralateral part of the normal brain parenchyma area （control group）. Results In this study, the ratios of Cho/Cr in the substantial region, 0-10 mm MZ of infiltration zone and the control group were 1.78＋0.70, 1.90＋_0.54, and 0.78＋_0.15, respectively; the ratios of NAA/Cr were 1.60＋0.20, 1.80＋0.42, 2.24＋_0.86, respectively; the ratios of （Lip＋Lac）/Cr were 25.69＋_13.84, 25.18＋16.03, and 0.61 ＋0.15, respectively. From the control group, 11-20 mm MZ to 0-10 mm MZ and the substantial region of CAE, the concentrations of the metabolites showed that NAA and Ch
