Objective To investigate the efficiency of hydrogen proton nuclear magnetic resonance spectroscopy (H1-MRS) in detection of cerebral parenchymal abnormalities, and the predict the value of clinical prognosis in children with febrile seizures (FS).
Methods Thirty-eight children with FS given treatments from March 2017 to May 2018 in general pediatrics department of Zhongshan City People Hospital were selected as research objects. All children were examined by brain MRI and H1-MRS, and the values of the metabolites N-acetylaspartic acid/(creatine+Creatine phosphate) [NAA/(Cr+Cho)], NAA/Cr and NAA/Cho were calculated according to the results of H1-MRS. Then, the differences in NAA/(Cr+Cho), NAA/Cr and NAA/Cho values between the children with and without poor clinical prognosis were compared according to the clinical poor prognosis of the children. The prognostic value of NAA/(Cr+Cho), NAA/Cr and NAA/Cho values were analyzed.
Results Among the 38 children with FS, 23 craniocerebral abnormalities cases were detected by MRI and 32 craniocerebral abnormalities cases were detected by H1-MRS, there was a statistically difference (χ2=5.330, P=0.021). Of the 38 children with FS, 13 had poor clinical prognosis and 25 had no poor clinical prognosis, the rate of complex type in the group with poor clinical prognosis was higher than that in the group without poor clinical prognosis, and there was a statistically difference (P<0.05). NAA/(Cr+Cho), NAA/Cr and NAA/Cho in the group with poor clinical prognosis were all lower than those in the group without poor clinical prognosis, showing statistically significant differences (P<0.05). The ROC curve of NAA/(Cr+Cho), NAA/Cr and NAA/Cho for predicting poor clinical prognosis was drawn, and the corresponding area under the curve (ACU) was 0.848, 0.774 and 0.797, respectively.
Conclusion The detection rate of brain parenchymal abnormalities by H1-MRS examination was higher than that by MRI examination, and the NAA/(Cr+Cho), NAA/Cr and NAA/Cho values calculated by H1-MRS results were significantly reduced in children with thermal convulsion. Among them, NAA/(Cr+Cho) values were of good predictive value for the prognosis of the children.