郑阳;王晓明;

• 1:中国医科大学附属盛京医院放射科

摘要(Abstract)：

目的应用酰胺质子转移成像(amide proton transfer,APT)联合磁化传递(magnetization transfer,MT)成像对新生儿从脑内环境角度评估新生儿脑损伤。材料与方法新生儿共38名,脑损伤13例,为病例组;常规MRI检查脑内无异常25例为对照组。常规MRI检查后补充APT-MT成像扫描。测量所有新生儿双侧额叶深部白质、基底节区、枕叶深部白质的APT值以及磁化传递率(magnetization transfer ratio,MTR)值(以下用APT/MTR表示),以及病例组病灶区及其对侧的APT/MTR值。采用SPSS 19.0软件进行统计分析。结果 (1)对照组中,额叶深部白质、基底节及枕叶深部白质APT/MTR值均有显著性差异(P<0.05)。(2)对照组中,APT/MTR值随孕龄增长而逐渐升高。(3)病例组病灶内APT/MTR值低于对侧(P<0.05)。结论围产期缺氧缺血是全脑代谢变化,APT-MT成像可从内环境及分子水平评估新生儿脑损伤。

关键词(KeyWords)： 磁共振成像;新生儿;脑;酰胺质子转移成像;磁化传递成像

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(编号:30570541、30770632、81271631)~~

作者(Author): 郑阳;王晓明;

Email:

DOI:

参考文献(References)：

• [1]Liu Y,Jissendi-Tchofo P,Metens T.MR imaging,diffusion imaging,and proton MR spectroscopy at 3T in full-term neonates with hypoxic-ischemic encephalopathy.Chin J Magn Reson Imaging,2011,2(1):13-18.
• [2]Malik GK,Pandey M,Kumar R,et al.MR imaging and in vivo proton spectroscopy of the brain in neonates with hypoxic ischemic encephalopathy.Eur J Radiol,2002,43(1):6-13.
• [3]Khong PL,Tse C,Wong IY,et al.Diffusion-weighted imaging and proton magnetic resonance spectroscopy in perinatal hypoxicischemic encephalopathy:association with neuromotor outcome at18 months of age.J Child Neurol,2004,19(11):872-881.
• [4]Wang HW,Wang XM,Guo QY.The correlation between DTI parameters and levels of AQP-4 in the early phases of cerebral edema after hypoxic-ischemic/reperfusion injury in piglets.Pediatr Radiol,2012,42(8):992-999.
• [5]Distefano G,PraticòAD.Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy.Ital J Pediatr,2010,36:63.
• [6]Uria-Avellanal C,Robertson NJ.Na+/H+exchangers and intracellular p H in perinatal brain injury.Transl Stroke Res,2014,5(1):79-98.
• [7]Hamakawa H,Murashita J,Yamada N,et al.Reduced intracellular p H in the basal ganglia and whole brain measured by 31P-MRS in bipolar disorder.Psychiatry Clin Neurosci,2004,58(1):82-88.
• [8]Casey JR,Grinstein S,Orlowski J.Sensors and regulators of intracellular p H.Nat Rev Mol Cell Biol,2010,11(1):50-61.
• [9]Schmidt H,Schwenzer NF,Gatidis S,et al.Systematic Evaluation of Amide Proton Chemical Exchange Saturation Transfer at 3 T:Effects of Protein Concentration,p H,and Acquisition Parameters.Invest Radiol,2016,51(10):635-646.
• [10]Zhou J,Payen J,Wilson DA,et al.Using the amide proton signals of intracellular proteins and peptides to detect p H effects in MRI.Nat Med,2003,9(8):1085-1090.
• [11]Yan K,Fu Z,Yang C,et al.Assessing amide proton transfer(APT)MRI contrast origins in 9 L gliosarcoma in the rat brain using proteomic analysis.Mol Imaging Biol,2015,17(4):479-487.
• [12]Zhou J,Wilson DA,Sun PZ,et al.Quantitative description of proton exchange processes between water and endogenous and exogenous agents for WEX,CEST,and APT experiments.Magn Reson Med,2004,51(5):945-952.
• [13]Jokivarsi KT,Grohn HI,Grohn OH,et al.Proton transfer ratio,lactate,and intracellular p H in acute cerebral ischemia.Magn Reson Med,2007,57(4):647-653.
• [14]Togao O,Kessinger CW,Huang G,et al.Characterization of lung cancer by amide proton transfer(APT)imaging:an in-vivo study in an orthotopic mouse model.PLo S One,2013,8(10):e77019.
• [15]Dula Adrienne N,Arlinghaus Lori R,Dortch Richard D,et al.Amide proton transfer imaging of the breast at 3 T:establishing reproducibility and possible feasibility assessing chemotherapy response.Magn Reson Med,2013,70(1):216-224.
• [16]Klomp Dennis WJ,Dula Adrienne N,Arlinghaus Lori R,et al.Amide proton transfer imaging of the human breast at 7 T:development and reproducibility.NMR Biomed,2013,26(10):1271-1277.
• [17]Jia G,Abaza R,Williams JD.Amide proton transfer MR imaging of prostate cancer:a preliminary study.J Magn Reson Imaging,2011,33(3):647-654.
• [18]Gerigk L,Schmitt B,Stieltjes B.7 Tesla imaging of cerebral radiation necrosis after arteriovenous malformations treatment using amide proton transfer(APT)imaging.J Magn Reson Imaging,2012,35(5):1207-1209.
• [19]Sun PZ,Zhou J,Sun W,et al.Detection of the ischemic penumbra using p H-weighted MRI.J Cereb Blood Flow Metab,2007,27(6):1129-1136.
• [20]Henkelman RM,Stanisz GJ,Graham SJ.Magnetization transfer in MRI:a review.NMR Biomed,2001,14(2):57-64.
• [21]Wen Z,Hu S,Huang F,et al.MR imaging of high-grade brain tumorsusing endogenous protein and peptide-based contrast.Neuroimage,2010,51(2):616-622.
• [22]Robertson NJ,Cowan FM,Cox IJ,et al.Brain alkaline intracellular p H after neonatal encephalopathy.Ann Neurol,2002,52(6):732-742.
• [23]Kucharczyk W,Macdonald PM,Stanisz GJ,et al.Relaxation and magnetization transfer of white matter lipidsat MR imaging:importance of cerebtosides and p H.Radiology,1994,192(2):521-529.
• [24]Zhou J.Amide proton transfer imaging of the human brain.Methods Mol Biol,2011,711:227-237.
• [25]Barkovich AJ,Kjos BO,Jackson DE Jr,et al.Normal maturation of the neonatal and infant brain:MR imaging at 1.5 T.Radiology,1988,166(1 pt 1):173-180.
• [26]Oishi K,Mori S,Donohue PK,et al.Multi-contrast human neonatal brain atlas:application to normal neonate development analysis.Neuroimage,2011,56(1):8-20.
• [27]Wang HW,Wang XM,Guo QY.The correlation between DTI parameters and levels of AQP-4 in the early phases of cerebral edema after hypoxic-ischemic reperfusion injury in piglets.Pediatric Radiology,2012,42(8):992-999.
• [28]Malik GK,Pandey M,Kumar R,et al.MR imaging and in vivo proton spectroscopy of the brain in neonates with hypoxic ischemic encephalopathy.Eur J Radiol,2002,43(1):6-13.
• [29]F e r n R,M?l l e r T.R a p i d i s c h e m i c c e l l d e a t h i n i m m a t u r e oligodendrocytes:a fatal glutamate release feedback loop.J Neurosci,2000,20(1):34-42.
• [30]Matute C,Alberdi E,Domercq M.The link between excitotoxic oligodendroglial death and demyelinating diseases.Trends Neurosci,2001,24(4):224-230.
• [31]Zhou J,Lal B,Wilson DA,et al.Amide proton transfer(APT)contrast for imaging of brain tumors.Magn Reson Med,2003,50(6):1120-1126.
• [32]Sun PZ,Zhou J,Huang Judy,at el.Simplified quantitative description of amide proton transfer(APT)imaging during acute ischemia.Magn Reson Med,2007,57(2):405-410.
• [33]Sun PZ,Wang E,Cheung JS.Imaging acute ischemic tissue acidosis with p H-sensitive endogenous amide proton transfer(APT)MRI:correction of tissue relaxation and concomitant RF irradiation effects toward mapping quantitative cerebral tissue PH.Neuroimage,2012,60(1):1-6.
• [34]Yilmaz U.Diffusion-weighted imaging in acute stroke.Radiologe,2015,5(9):771-774.
• [35]Liu D,Zhou J,Xue R,et al.Quantitative characterization of nuclear overhauser enhancement and amide proton transfer effects in the human brain at 7 tesla.Magn Reson Med,2013,70(4):1070-1081
• [36]Zhou J,Payen J,van Zijl PC.The interaction between magnetization transfer and blood-oxygen level-dependent effects.Magn Reson Med,2005,53(2):356-366.
• [37]Scheidegger R,Vinogradov E,Alsop DC.Amide proton transfer imaging with improved robustness to magnetic field inhomogeneity and magnetization transfer asymmetry using saturation with frequency alternating RF irradiation.Magn Reson Med,2011,66(5):1275-1285.