Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Neuronal Dysfunction in Patients with Chronic Alcoholism Evaluated by In Vivo $^1H$ Magnetic Resonance Spectroscopy

알콜중독환자의 신경기능 장애: 생체 양성자 자기공명분광 연구

  • Bo-Young Choe (Departments of Biomedical Engineering, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Euy-Neyng Kim (Departments of Radiology, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chang-Wook Lee (Departments of Psychiatry, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • In-Ho Baik (Departments of Psychiatry, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kwang-Soo Lee (Departments of Neurology, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Byung-Chul Son (Departments of Neurosurgery, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Heung-Jae Chun (Departments of Biomedical Engineering, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyoung-Koo Lee (Departments of Biomedical Engineering, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Tae-Suk Suh (Departments of Biomedical Engineering, Kangnam St. Mary′s Hospital, College of Medicine, The Catholic University of Korea)
  • Published : 2000.12.01
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Abstract

Purpose : With the use of localized, water-suppressed in vivo $^1H$ magnetic resonance spectroscopy (MRS), we evaluated the proton metabolic alterations in patients with chronic alcoholism and healthy normal controls. Material and Methods : Patients with chronic alcoholism (N = 10) and normal control subjects (N = 10) underwent MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence with $2{\times}2{\times}2{\;}\textrm{cm}^3$ volume of interest (VOI) in the left cerebellum and basal ganglia. Proton metabolite ratios relative to creative (Cr) were obtained using a Marquart algorithm. Results : The specific feature in patients with chronic alcoholism was a significant decrease of N-acetylaspartate (NAA)/Cr ratio in the left cerebellum, compared with normal controls. No clear correlation of other metabolite ratios such as choline (Cho)/Cr and inositols (Ins)/Cr was established. Conclusion : Our preliminary study suggests that the reduction of NAA/Cr ratio may indicate neuronal loss in patients with chronic alcoholism. Thus, in vivo 1H MRS may be a useful modality in the clinical evaluation of patients with chronic alcoholism based on the proton metabolite ratios.

목적 : 국한적 수분억제 생체내 양성자 자기공명분광학을 사용하여 만성 알코을 중독자와 정상 건강인의 뇌대사물질의 비율을 비교평가하였다. 대상 및 방법 : 만성 알코을 중독자 10명,정상 건강인 10명의 좌측 소뇌와 basal ganglia의 관심부위 $2{\times}2{\times}2{\;}\textrm{cm}^3$를 각각 선택하여 STEAM펄스시퀀스를 이용하였다 Creatine (Cr)을 기준으로 Marquart알고리즘을 이용하여 각 대사물질의 비율을 산출하였다. 결과 만성 알코을 중독자의 특징적인 소견은 정상인과 비교하여 볼 때 N-acetyl aspartate (NAA)/Cr비율이 감소하였다. 그러나 Choline (Cho)/Cr등 다른 대사비율은 정상인과 유이한 차이를 발견할수 없었다. NAA/Cr비율은 임상평가와 상당한 상호관계가 있는 것으로 나타났다. 결론 : 본 예비실험 결과는 만성 알코을 중독자의 NAA/Cr의 비율 감소를 토대로 환자 소뇌의 신경세포 소실을 추정할 수 있었다. NAA/Cr비율은 향후 만성 알코을 중독자의 임상평가를 추정할수 있는 대사표준으로 사용될 수 있음을 시사해주고 있다. 따라서 생체내 양성자 자기공명분광법은 양성자 비율을 토대로 만성 알코을 중독자의 임상평가에 유용한 방법으로 사용될 수 있으리라 사료된다.

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