单纯脊髓受累型多发性硬化患者脑结构和脑功能的MRI研究

发布时间：2018-02-21 10:36

本文关键词： 多发性硬化脊髓疾病磁共振成像静息态图像处理计算机辅助功能网络　出处：《中国医学影像学杂志》2015年10期 　论文类型：期刊论文

【摘要】：目的脊髓是多发性硬化(MS)的好发部位之一,严重影响患者生活质量。本文探讨基于体素的形态学(VBM)方法及静息态功能磁共振成像(RS-f MRI)在单纯脊髓受累的多发性硬化(MS-SSCI)患者中的应用价值。资料与方法 20例MS-SSCI患者及对照组20例健康志愿者行3D T1WI及RS-f MRI扫描,通过VBM方法分析脑灰质及白质体积、全脑体积、局部核团体积变化情况,以后扣带回(PCC)作为种子点行全脑静息态功能连接分析并行组间比较,进一步分析MS-SSCI结构、功能变化参数与临床扩展残疾状态量表(EDSS)评分的相关性。结果 1 MS-SSCI组较对照组全脑灰、白质体积、全脑体积未见明显变化(P0.05),双侧颞中回、左侧颞下回灰质体积萎缩(P0.01);左侧内侧前额叶、左侧颞下回、左侧尾状核、右侧补充运动区与PCC之间的功能连接(FC)明显升高(双样本t检验,经Alpha Sim校正,P0.05,体素大小40);2 MS-SSCI结构变化参数与EDSS评分均无明显相关性(P0.05);左侧颞下回FC值与EDSS评分呈正相关(r=0.63,P0.05)。结论MS-SSCI脑内结构及PCC的FC均发生改变,但仅功能变化参数与临床残疾状况相关,提示功能活动异常较微结构损伤更加敏感。
[Abstract]:Objective the spinal cord is one of the most common sites of multiple sclerosis (MS). The quality of life (QOL) of patients was seriously affected. The value of VBM-based morphologic method and resting functional magnetic resonance imaging RS-f MRI in patients with multiple sclerosis (MS SSCI) with simple spinal cord involvement was investigated. Data and methods 20 cases of patients with multiple sclerosis. MS-SSCI patients and 20 healthy volunteers were examined by 3D T1WI and RS-f MRI. The changes of gray matter and white matter volume, whole brain volume and local nucleus volume were analyzed by VBM method. The posterior cingulate gyrus (PCC) was used as seed point to analyze the functional connections in resting state of the whole brain. The structure of MS-SSCI was further analyzed. Results 1 compared with the control group, there were no significant changes in the whole brain gray, white matter volume and whole brain volume in the MS-SSCI group (P 0.05) and bilateral middle temporal gyrus. The volume atrophy of gray matter in the left inferior temporal gyrus was significantly higher than that in the left medial prefrontal lobe, left inferior temporal gyrus, left caudate nucleus, right supplementary motor area and PCC (double sample t test). After Alpha Sim correction, there was no significant correlation between the MS-SSCI structure parameters and the EDSS score, and the FC value of left infratemporal gyrus was positively correlated with the EDSS score. Conclusion the structure of MS-SSCI and the FC of PCC have been changed. However, only functional parameters were related to clinical disability, suggesting that abnormal functional activity was more sensitive than microstructural damage.
【作者单位】：重庆医科大学附属第一医院放射科;
【基金】：国家自然科学基金项目(81371523) 重庆市卫生局资助项目(2011-1-031,2012-1-017) 国家临床重点专科建设项目([2013]544)
【分类号】：R744.51;R445.2

【参考文献】