Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.

Objective To investigate the clinical efficacy and indications of stereotactic endoscopic evacuation in spontaneous hypertensive hemorrhage of the basal ganglia.Methods Twelve patients with spontaneous hypertensive hemorrhage of the basal ganglia,admitted to our hospital from October 2012 to October 2013,were treated by stereotactic endoscopic hematoma evacuation.Their clinical data were collected and retrospectively analyzed.Results Mean operative time was (1.6±0.5) h.Postoperative CT showed that 4 received evacuation of 70％-90％ of hematomas,and 8 did 90％.No intracerebral hemorrhage recurred in the patients.The follow up for 6 months after the operation was performed in 12 patients;according to Glasgow outcome scale scores,the excellent curative effects were achieved in 3 patients,good ones in 4,fare ones in 4 and death in one.Conclusion Stereotactic endoscopic hematoma evacuation enjoys characteristics as precision,minimal invasion,short operation time and high hematoma evacuation.