非神经精神性红斑狼疮患者脑白质结构的弥散张量成像研究

发布时间：2018-01-27 02:04

本文关键词： 非神经精神性红斑狼疮弥散张量成像基于纤维束示踪的空间统计概率性纤维追踪结构网络图论分析　出处：《南方医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：神经精神性狼疮(neuropsychiatric systemic lupus erythematosus,NPSLE)是当系统性红斑狼疮累及中枢及周围神经系统时产生的并发症。在NPSLE发病早期,没有出现神经精神性临床症状时被称为非神经精神性狼疮(non-NPSLE)。近年研究发现non-NPSLE患者的大脑已经出现了脑结构和脑功能的异常,其中白质受损被认为是相对重要的因素。弥散张量成像(diffusion tensor imaging,DTI)是能够无创性地获取白质中神经纤维走行及髓鞘信息的影像学技术。本文利用两种基于DTI的分析方法,研究non-NPSLE患者与正常对照组(healthy control,HC)之间白质结构的差异。第一部分研究是利用基于DTI的纤维束示踪空间统计(tract-based spatial statistics,TBSS)方法分析脑白质微结构。实验选用经过纳入及排除标准筛选后的29例non-NPSLE女性患者与29例女性志愿者作为两组被试采集图像数据。通过FSL软件的标准处理步骤与流程,计算得到两组被试自身的部分各向异性(fractional anisotropy,FA)骨架图,再对FA骨架图进行组间全脑显著性差异的统计学分析。实验结果显示:与HC组相比,non-NPSLE组的FA值主要在胼壿体体部、胼胝体压部、胼胝体膝部、双侧前放射冠、双侧上纵束、双侧上放射冠、双侧外囊、右侧丘脑后辐射等位置显著降低。结果提示患者组的大脑白质完整性降低,白质髓鞘的微小结构以及轴突可能存在异常。第二部分的研究是利用基于DTI的脑网络分析方法研究白质结构网络,使用概率性纤维束追踪技术以及图论分析探究患者组全脑水平上的白质连接以及网络拓扑属性的异常。脑网络分析方法的基本流程为:数据预处理;基于标准AAL模板划分大脑为90个功能脑区;使用概率性纤维束追踪重建白质纤维,构建结构网络矩阵;计算网络的各项拓扑量度;统计学分析。实验结果为:(1)non-NPSLE组的全局网络效率与局部网络效率显著降低,特征路径长度显著增加,反映网络的信息整合及交换能力受损;(2)当节点的度为度量参数时,non-NPSLE组的中枢节点分布改变;(3)non-NPSLE组的节点效率在右岛盖部额下回、右三角部额下回以及左内侧和旁扣带脑回处显著降低,节点的度在右岛盖部额下回、左右内侧和旁扣带回、右梭状回、右楔前叶处显著降低,节点的度在左眶部额上回、左枕下回处显著增加,这些脑区涉及语言功能、视觉功能以及默认网络等功能;(4)non-NPSLE组的网络全局效率、局部效率以及部分异常脑区的节点效率和度与疾病活动指数具有显著负相关;(5)non-NPSLE组出现一个连接显著降低的子网络以及两个连接显著增强的子网络。本文中两项基于DTI的研究发现:non-NPSLE患者的白质纤维束完整性在部分区域出现显著性降低;白质连接网络的拓扑结构与HC有显著差异。研究结果为进一步研究NPSLE早期的发病机制提供影像学依据。
[Abstract]:Neuropsychiatric systemic lupus erythematosus. NPSLE is a complication that occurs when systemic lupus erythematosus is involved in the central and peripheral nervous systems. Patients without neuropsychiatric symptoms are referred to as non-neuropsychiatric lupus (non-NPSLEs). In recent years, it has been found that the brain of patients with non-NPSLE has abnormal brain structure and function. The white matter damage is considered to be a relatively important factor. Diffusion Zhang Liang imaging diffusion tensor imaging. DTI) is an imaging technique that can obtain the information of nerve fiber walking and myelin sheath in white matter in a noninvasive way. Two analysis methods based on DTI are used in this paper. To study healthy control in non-NPSLE patients and normal controls. The first part of the study was to use tract-based spatial statistics based on tracer space of fiber bundle based on DTI. TBSS). Methods the microstructures of white matter were analyzed. Twenty-nine female non-NPSLE patients and 29 female volunteers were selected as two groups to collect image data by FS. The standard processing steps and processes of L software. Two groups of partial anisotropic fractional anisotropic FAA skeleton diagrams were obtained. Compared with HC group, the FA value of non-NPSLE group was mainly located in callosal body and corpus callosum. The genu of corpus callosum, bilateral anterior radiative corona, bilateral superior longitudinal bundle, bilateral superior coronal, bilateral external capsule and right posterior thalamic radiation were significantly decreased. The results indicated that the integrity of the white matter of the cerebrum was decreased in the patients group. The microstructures and axons of the white matter myelin sheath may be abnormal. The second part is to study the white matter structure network using the brain network analysis method based on DTI. Probabilistic fiber bundle tracing technique and graph theory analysis were used to explore the white matter connection and the abnormal topological properties of the network at the whole brain level in the patient group. The basic process of the brain network analysis method was as follows: data preprocessing; The brain was divided into 90 functional brain regions based on standard AAL template. Using probabilistic fiber bundles to track and reconstruct white matter fibers, structure network matrix was constructed. Calculate the topological metrics of the network; The experimental results showed that the global network efficiency and local network efficiency of the non-NPSLE group were significantly decreased, and the length of the characteristic path was significantly increased. The information integration and exchange ability of the network is damaged; (2) the distribution of central nodes in non-NPSLE patients was changed when the degree of nodes was a metric parameter. In the non-NPSLE group, the nodal efficiency was significantly decreased in the inferior frontal gyrus of the right tegmental part, the inferior frontal gyrus of the right triangular part and the left medial and accessory cingulate gyrus, and the degree of the node was in the inferior frontal gyrus of the right tegmental part. The left and right medial and accessory cingulate gyrus, right fusiform gyrus, right anterior cuneate lobe decreased significantly, the degree of nodes in left orbital superior frontal gyrus and left inferior occipital gyrus increased significantly. Visual function and default network function; In non-NPSLE group, the global network efficiency, local efficiency and node efficiency and degree of some abnormal brain regions were negatively correlated with disease activity index. 5). In the non-NPSLE group, there is a subnetwork with significantly reduced connections and two significantly enhanced subnetworks. Two DTI based studies in this paper found that:. The integrity of white matter fiber bundle in non-NPSLE patients decreased significantly in some areas. The topological structure of the white matter junction network is significantly different from that of HC. The results provide imaging evidence for further study of the pathogenesis of NPSLE in the early stage.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：TP391.41;R593.241;R747.9

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