静息态功能磁共振影像技术在脑震荡综合征患者脑结构网络中的应用研究

发布时间：2018-04-12 05:58

本文选题：功能磁共振成像 + 脑震荡综合征　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的采用静息态功能磁共振脑功能显像技术,构建脑震荡综合征患者(Post-concussion syndrome,PCS)的脑结构网络,通过研究其网络属性的变化探讨脑震荡综合征的病理生理机制:(1)应用功能磁共振弥散张量成像技术(diffusion tensor imaging,DTI)观察脑震荡综合征患者大脑白质纤维网络细微结构的损伤并探讨其改变的意义;(2)应用功能磁共振成像中的基于体素的形态学测量(Voxel based morphometry,VBM)和计算机图形辅助处理技术,探讨脑震荡后综合征患者大脑灰质体积的变化及其意义。方法(1)选取18例脑震荡综合征被试均招募于安徽医科大学附属省立医院神经外科门诊2015年4月至2015年9月接诊的轻度脑外伤患者组成患者组,同期在社会上招募性别、年龄、教育程度与轻度颅脑损伤组患者均匹配的18名健康人组成正常对照组,所有受试者均在受伤后3个月接受相同参数的静息态磁共振成像数据采集,数据使用FSL软件经涡流矫正、张量计算、空间标准化、计算FA值,通过与正常对照组随机化统计比较并校正后得到脑白质纤维束网络发生损伤的区域;(2)以2015年4月至2016年1月期间安徽医科大学附属省立医院神经外科收治的23例脑震荡综合征患者为患者组,以及同期招募的25名健康人为对照组,经静息态功能磁共振检查后获得数据,使用SPM8中VBM软件包经过图像标准化变换、配准、图像成分分割、平滑及统计分析后,发现两组灰质体积存在差异的部位,提取差异有统计学意义的结果并直观显示。结果(1)使用约翰霍普金斯大学脑白质模板(JHUWM)进行定位发现:相对于正常组,患者组的FA值降低区域包括:胼胝体膝部和体部、双侧前放射冠、左侧丘脑后辐射(包括视辐射束)和右侧外囊;未发现FA值增高的区域。(2)基于VBM研究方法可见:与对照组相比,脑震荡综合征患者组的大脑灰质体积减小的脑区包括额叶(左侧额下回、右侧额直回)、颞叶(左侧颞下回)、左侧岛盖和左侧壳核;与对照组相比,未发现灰质体积明显增大的脑区。结论(1)TBSS方法发现轻度颅脑损伤患者大脑白质纤维束的细微结构异常,可能与脑震荡综合征患者伤后出现症状的病理生理机制及临床表现密切相关。(2)脑震荡后综合征患者的大脑灰质体积存在结构性异常改变,主要表现为局部萎缩性变化,推测这种变化可能与脑震荡后综合征所产生的多种迁延不愈的临床表现的病理机制有关。综上,本研究采用静息态功能磁共振的脑功能成像技术,能够显示出脑震荡综合征患者伤后大脑白质及灰质组成的结构网络均出现了细微的异常变化,为对于PCS的致病机制的研究提供新的方向,为脑创伤的诊治提供了新的理论依据。
[Abstract]:Objective to construct a brain structure network of Post-discussion syndrome (PCS) in patients with concussion syndrome by resting functional magnetic resonance imaging (fMRI).Study on the pathophysiological mechanism of concussion syndrome by studying the changes of its network properties: 1) use functional magnetic resonance diffusion Zhang Liang imaging technique to observe the fine structure of cerebral white matter fiber network in patients with concussion syndromeApplication of Voxel based morphometry and computer Graphics in functional Magnetic Resonance Imaging.To investigate the changes and significance of gray matter volume in patients with postconcussion syndrome.Methods 18 patients with concussion syndrome were recruited from the Department of Neurosurgery, Anhui Medical University, from April 2015 to September 2015.Eighteen healthy persons with education level matched with those of mild craniocerebral injury group constituted a normal control group. All subjects received the same parameters of resting magnetic resonance imaging data at 3 months after injury, and the data were corrected by eddy current using FSL software.Zhang Liang calculation, spatial standardization, calculation of FA value,23 cases of neurosurgery in Provincial Hospital affiliated to Anhui Medical University between April 2015 and January 2016 were obtained by comparing and correcting the randomization statistics of the white matter bundle network in the normal control group from April 2015 to January 2016.Concussion syndrome patient group,The data were obtained by resting functional magnetic resonance imaging (fMRI) and 25 healthy persons recruited in the same period. The VBM software package in SPM8 was used for image standardization transformation, registration, image component segmentation, smoothing and statistical analysis.The difference of gray matter volume between the two groups was found.Results using Johns Hopkins White matter template (JHUWM), we found that the decreased FA values in the patients group included the genu and body of corpus callosum, bilateral anterior radiographic corona.The left posterior thalamic radiation (including the visual radiation beam) and the right outer capsule; the area where FA value was not found to be increased was observed based on the VBM method: compared with the control group,In concussion syndrome group, the areas of reduced gray matter volume included frontal lobe (left inferior frontal gyrus, right frontal gyrus, temporal lobe (left infratemporal gyrus, left insular cap and left putamen nucleus), compared with control group.No significant increase in gray matter volume was found in the brain.Conclusion the fine structure of white matter fiber bundle in patients with mild craniocerebral injury was found by TBSS method.It may be closely related to the pathophysiological mechanism and clinical manifestation of posttraumatic symptoms in patients with concussion syndrome. (2) there are structural abnormal changes in gray matter volume in the brain of patients with postconcussion syndrome, mainly manifested as local atrophic changes.It is speculated that this change may be related to the pathological mechanism of many delayed clinical manifestations of postconcussion syndrome.In conclusion, using resting functional magnetic resonance imaging technique, this study can show slight abnormal changes in white matter and gray matter structure network in patients with concussion syndrome.It provides a new direction for the study of the pathogenesis of PCS and a new theoretical basis for the diagnosis and treatment of brain trauma.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R651.15

【参考文献】