中文摘要：

目的 分析结节性硬化症病人皮质结节的质子磁共振波谱特征，理解皮质结节的病理形成。方法 收集我院有完整波谱资料的25例临床确诊结节性硬化症病人，单体素质子磁共振波谱采集皮质结节和对侧半球MRI正常的对应脑区，比较两侧代谢物和各代谢物与Cr比值。结果25例病人采集50个单体素波谱，均未显示Lac峰，两侧Cr峰对称。25例皮质结节NAA峰较对侧低，NAA／Cr值1．33～1．57，平均NAA／Cr值（1．46±0．07）；正常对侧1．49～1．78，平均NAA／Cr（1．54±0．11）（t=3．024，P=0．004）。25例皮质结节Cho／Cr值（1．02±0．12），正常对侧是（1．00±0．15）（t=0．339，P=0．736）。结论结节性硬化症皮质结节NAA／Cr降低，Cho峰无明显升高，反映皮质结节NAA减少，提示皮质结节是由不成熟神经元和／或没有NAA表达的神经胶质组成的病理特征。

英文摘要：

Objective To analyze the feature of proton MR spectroscopy （^1H MRS） of cortical tubers in tuberous sclerosis complex and to explain the pathology of cortical tuber. Methods Single-voxel PRESS ^1H MRS were performed in 25 patients with clinically confirmed tuberous sclerosis complex. Region of interest included the cortical tubers and corresponding regions in the contralateral hemisphere. Then the both-side metabolites and the ratios of NAA/Cr and Cho/Cr were compared. Results Fifty single-voxel ^1H MRS showed symmetric Cr peak and absence of Lac peak. The ratio of NAA/Cr （medium value 1.46±0.07;range 1.33-1.57） in 25 cortical tubers was significantly lower （t=3. 024, P=0. 004） than that （medium value 1.54±0.11 ; range 1.49-1.78 ） of normal side. However, no significant differences （t=0. 339, P=0. 736） were found in the mean ratio of Cho/Cr between cortical tubers （1.02±0.12） and normal side （1.00±0.15）. Conclusion NAA/Cr of cortical tuber in tuberous sclerosis complex significantly decreases, but Cho is stable, as explain that possible pathological characteristics are immature neuron and/or glia.