目 的 探讨氢质子波谱成像 (magnetic resonance spectroscopy, MRS)在锥体束继发性华勒氏变性 (Wallerian degeneration, WD)的应用 价值。方法 回顾性分析经临床确诊累及 单侧锥体束走行区的病变并继发WD病例 60例，在常规MRI序列上对病灶信号特征 及分布特点进行分析，并对MRS患侧大脑 脚感兴趣区的NAA、Cho、Cr、NAA/Cr、 Cho/Cr进行统计分析。结果 WD的MRI表现 为T1WI呈等或稍低信号，T2WI呈稍高信 号，FLAIR呈稍高信号，可伴或不伴有患 侧大脑脚、丘脑及桥脑等萎缩；患侧大 脑脚NAA、NAA/Cr均低于健侧，差异有统 计学意义(P<0.05)，患侧与健侧大脑脚 的Cho、Cr、Cho/Cr相仿，差异无统计学 意义(P>0.05)。结论 常规MRI大部分可 检出WD病灶，但是MRS技术可通过分子水 平定量反映变性部分脑组织的病理生理 改变，为临床诊疗提供影像学证据。

Objective To investigate the application value of hydrogen proton spectroscopy (MRS) in the pyramidal tract secondary Wallerian's degeneration (WD). Methods To have a retrospective analysis on the clinical diagnosis of unilateral pyramidal tract lesions and secondary WD 60 cases. In the conventional MRI (T1WI, T2WI and FLAIR) focus on the image of the signal characteristic and distribution characteristic is analyzed, and interested in MRS of lateral cerebral peduncle the NAA, Cho, Cr, NAA/Cr, Cho/Cr were analyzed. Results MRI manifestation of WD to similar or long T1, long T2 signal, FLAIR is slightly higher, at the same time can be associated with brain atrophy of lateral cerebral peduncle, thalamus and bridge; NAA, NAA/Cr of the affected side are lower than the healthy side, the difference was statistically significant (P<0.05) while Cho, Cr, Cho/ Cr were not statistically different (P>0.05). Conclusion Most conventional MRI can be detected with WD lesions, MRS technology can quantitatively reflect the modified part of the brain tissue by molecular level of pathophysiological changes, which can confirm the existence of the WD.