| Objective: To investigate the relationship between multi-voxel proton magnetic resonance spectroscopy(1H-MRS)metabolite changes and clinical scores during hospitalization of patients with cerebral infarction,and to evaluate the value of multi-voxel 1H-MRS in predicting the prognosis of patients with cerebral infarction.Methods: A total of 43 patients with cerebral infarction who underwent neurology hospitalization from April 2017 to December 2018 in Yanjishan Hospital of Weinan Medical College were enrolled.In the guidelines for diagnosis and treatment,43 patients with cerebral infarction underwent two multi-voxel 1H-MRS scans before and after hospitalization,and metabolites were obtained after post-treatment.According to the onset time,43 patients were divided into acute phase and subacute phase.In the group,18 patients with acute cerebral infarction within 3 days of onset,and 25 patients with subacute cerebral infarction within 4-7 days.The National Institutes of Health Neurological Deficit(NIHSS)score was assessed prior to two multi-voxel 1H-MRS examinations.The changes in metabolites before and after treatment were then correlated with changes in NIHSS scores.Results: 1.At the time of admission,43 patients underwent CT scan results: 15 patients had no abnormalities,but the clinical manifestations were unclear articulation and partial weakness of the limbs;28 lesions showed patchy low-density shadows.The results of routine magnetic resonance imaging in 43 patients: all 43 patients showed abnormalities,DWI showed high signal;43 patients with cerebral infarction showed magnetic resonance spectroscopy: the NAA peak of the lesion center area and lesion edge area decreased before treatment.The lactic acid peak increased to some extent,and some of them showed inverted double peaks.After treatment,the NAA peak in the central region of the lesion did not change significantly,and some of them decreased further.After treatment,the NAA peak of the lesion edge area increased,but the NAA peak was still lower than the contralateral normal.In the region,the peak of lactic acid is partially reduced and partially disappears.2.The changes of rNAA value and rLac value in the central area of the lesions before and after treatment were studied in 43 patients.The results showed that the rNAA values of the acute and subacute phases of the lesions in 43 patients were not statistically significant before treatment.(P>0.05);the rLac value after treatment in the acute and subacute patients in the central area of the lesion was lower than that before treatment,and there was statistical significance(P<0.05).3.The changes of rNAA value and rLac value in 43 patients before and after treatment were studied.The results showed that the rNAA values of 43 patients with acute and subacute patients after treatment were higher than those before treatment.The significance of learning(P<0.05);the acute and subacute patients in the marginal zone of the lesions after treatment was lower than the pre-treatment,statistically significant(P<0.05).4.The changes of clinical NIHSS scores before and after treatment in 43 patients were studied.The results showed that the pre-treatment NIHSS scores ranged from 5-15 points to mean(9.95±2.80)points.The NIHSS score ranged from 2-12 after treatment.Points,average(5.37 ± 2.33)points.The NIHSS scores of 43 patients were lower than those before treatment,and the difference was statistically significant(t=16.92,p<0.05).5.Correlation analysis of the difference between the difference of rNAA value and the decrease of rLac value in the central area of the lesion before and after treatment was compared with the difference of NIHSS score before and after treatment.The results showed that the difference between rNAA value and NIHSS There was no correlation between the differences in scores(r=0.142,p>0.05);there was no correlation between the difference in rLac values and the difference in NIHSS scores(r=0.135,p>0.05).6.Correlation analysis showed that the difference between the difference of rNAA value and the decrease of rLac value in the marginal zone of 43 patients before and after treatment was lower than the difference of NIHSS score before and after treatment.The results showed that the difference of rNAA value increased with NIHSS.There was a positive correlation between the difference in scores(r=0.613,p<0.05);there was no correlation between the difference in the decrease in rLac and the decrease in NIHSS score(r=0.213,p>0.05).Conclusion: 1、through the characteristics of the pre-treatment lesions of the NAA peak and Lac peak changes,can be used for early diagnosis of cerebral infarction;2、After treatment,patients with cerebral infarction showed no significant recovery of neurons in the central region of the lesion,while lactic acid accumulation was reduced.3、in patients with cerebral infarction,the neurons in the marginal area of the lesion have recovered,and the accumulation of lactic acid has also been reduced;4、The change of rNAA value before and after treatment in patients with cerebral infarction can evaluate the prognosis of patients with cerebral infarction;5、In summary,through magnetic resonance routine examination and measurement of multi-voxel 1H-MRS partial metabolites and clinical related research,can be used for early diagnosis of cerebral infarction,and can assess the clinical prognosis of patients. |
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