扩散张量成像对多发性硬化和视神经脊髓炎患者视放射区的研究

发布时间：2018-05-22 07:41

本文选题：磁共振成像 + 扩散张量成像　；参考：《重庆医科大学》2016年硕士论文

【摘要】：第一章 DTI对复发-缓解型多发性硬化患者双侧视放射的研究目的:应用DTI(diffusion tensor imaging)技术探讨复发-缓解型多发性硬化(RRMS)患者视力损伤与双侧视放射白质纤维束损伤的相关性。方法:视力损伤的RRMS患者及年龄与性别相匹配的健康志愿者各25例行DTI检查,分别测量双侧视放射的FA值及MD值,并采用扩展残疾状态量表(EDSS)对患者进行评分。应用SPSS17.0配对t检验及两样本t检验分别分析RRMS患者及健康对照组组内及组间两侧视放射的FA值及MD值,以及与EDSS评分的相关性。结果:(1)健康对照组及患者组组内双侧视放射FA值(t=0.41,P=0.68;t=0.09,P=0.92)及MD值(t=0.72,P=0.48;t=0.20,P=0.84)均没有显著差异(P0.05);多发性硬化患者左右两侧视放射FA值(t=8.29,P=0.00;t=8.42,P=0.00)均比正常对照组显著下降,MD值(t=7.17,P=0.00;t=6.58,P=0.000)均比正常对照组显著升高(P0.05);(2)双侧视放射FA值(r=-0.244,P=0.30;r=-0.133,P=0.58)及MD值(r=0.160,P=0.50;r=0.307,P=0.19)与EDSS评分均没有明显的相关性(P0.05)。结论:RRMS患者视力受损与双侧视放射的白质纤维束损害相关;DTI作为一种无创定量测量白质纤维束的MRI检查方法,可为RRMS患者视力损害病理改变提供影像学帮助。第二章复发-缓解型多发性硬化患者及复发型视神经脊髓炎患者双侧视放射的DTI研究目的:运用扩散张量成像(diffusion tensor imaging,DTI)技术探讨复发-缓解型多发性硬化(RRMS)和复发型视神经脊髓炎(RNMO)患者看似正常视放射区DTI指标是否存在差异。方法:RRMS患者、RNMO患者及年龄与性别相匹配的健康志愿者各20例行DTI检查,分别测量双侧视放射的FA值及MD值,并采用扩展残疾状态量表(EDSS)对两组患者进行评分。应用SPSS17.0配对t检验、单因素方差分析及Dunnett-t检验分别分析患者组及健康对照组组内及组间两侧视放射的FA值及MD值,以及用Spearman软件分析DTI定量值与EDSS评分的相关性。结果:(1)健康对照组、RRMS及RNMO患者组组内双侧视放射FA值(t=0.41,P=0.68;t=0.10,P=0.92;t=0.63,P=0.54)及MD值(t=0.72,P=0.48;t=0.20,P=0.84;t=0.20,P=0.84)均没有明显差异(P0.05);RRMS及RNMO患者组左右两侧视放射FA值(P=0.00;P=0.00)均比健康对照组显著下降,MD值(P=0.00;P=0.00)均比健康对照组显著升高(P0.05);RNMO组双侧视放射FA值比RRMS组下降(P=0.02),而MD值(P=0.50)无明显差别;(2)RRMS组及RNMO组双侧视放射FA值(r=-0.19,P=0.42;r=0.20,P=0.41)及MD值(r=0.11,P=0.64;r=-0.33,P=0.15)与EDSS评分均没有明显的相关性(P0.05)。结论:RRMS及RNMO患者看似正常的视放射区均有受累,但二者视放射受累的程度不一致,FA值对鉴别MS及NMO具有潜在的应用价值,并可作为监测MS及NMO临床进展的重要生物学指标。
[Abstract]:Chapter 1 study of dual lateral radiography in patients with relapse-remission multiple sclerosis objective: to investigate the correlation between visual impairment and white matter fiber bundle injury in patients with relapse-remission multiple sclerosis by using DTI(diffusion tensor imaging technique. Methods: 25 RRMS patients with visual impairment and 25 healthy volunteers matched with age and sex were examined by DTI. FA and MD were measured respectively. The patients were evaluated with extended Disability status scale (EDSS). SPSS17.0 paired t test and two sample t test were used to analyze the FA value and MD value of bilateral visual radiation in patients with RRMS and healthy control group, and the correlation between FA and EDSS score. Results (1) there was no significant difference between healthy control group and patient group (P = 0.41) and MD value (t = 0.72 ~ 0.48 ~ 0.48 ~ 0.20 / P ~ (0.84). There was no significant difference between healthy control group and patient group (P ~ (0.05); in patients with multiple sclerosis, there was no significant difference in both sides (t ~ (8.29) P ~ (0. 000) P ~ (0.002) T ~ (8.42) and there was a significant decrease in MD value (t ~ (7.17) P ~ (0.008) P ~ (0.000) in patients with multiple sclerosis. In the irradiation group, there was no significant correlation between EDSS score and FA value (r = 0.244U, P = 0.30U, P = 0.133a, P = 0.58) and MD (n = 0.160, P = 0.307a, P = 0.19) in the two groups (P < 0.05). The results showed that there was no significant correlation between the mean value of FA and the score of EDSS in the exposure group (P < 0.05), but no significant correlation was found between the two groups (P < 0.01) and the EDSS score (P < 0.05). Conclusion as a noninvasive MRI method for quantitative measurement of the white matter bundle in patients with RRMS, the visual impairment associated with the damage of white matter bundles by dual-lateral radiography can provide imaging assistance for the pathological changes of visual impairment in patients with RRMS. Chapter 2 DTI study of dual Lateral Radiography in patients with recurrent and remission multiple Sclerosis and recurrent Optic Neuromyelitis objective: to investigate the recurrence and remission of multiple sclerosis by diffused Zhang Liang diffusion tensor imaging technique Whether there are differences in DTI indices in the seemingly normal visual radiation area in patients with type A optic neuromyelitis (RNMO). Methods 20 patients with RNMO and 20 healthy volunteers with age and sex matched with RRMS were examined by DTI. FA and MD were measured respectively. The patients in both groups were evaluated with extended Disability status scale (EDSS). SPSS17.0 paired t test, single factor analysis of variance and Dunnett-t test were used to analyze the FA and MD values of bilateral visual radiation in patients group and healthy control group, and Spearman software was used to analyze the correlation between DTI quantitative value and EDSS score. Results (1) there was no significant difference in the FA value of RRMS and RNMO patients in the healthy control group and in the patients with RNMO. The values of FA in the RMS and RNMO groups were significantly lower than those in the healthy control group (P 0.00P 0.00P0. 00P) and the MD values of 0. 72P 0. 48t 0. 20 P0. 84t 0. 20 P0. 804 P0. 84) were significantly lower than those of the healthy control group (P 0. 00P 0. 00P 0. 00P 0. 00P 0. 004) and that of the patients with RNMO was significantly lower than that of the healthy control group (P 0. 00P 0. 00P 0. 00P 0. 0. 20 P0. 84t 0. 20 P0. 20 P0. 20 P0. 20 P0. 20 P0. 84). All of them were significantly lower than those of the healthy control group. Compared with RRMS group, there was no significant difference in the FA value of dual lateral radioactivity between RNMO group and RNMO group. There was no significant difference between RMS group and RNMO group. There was no significant correlation between the FA value of RMS group and RNMO group (P 0. 020 P 0. 41) and MD value of 0. 11 ~ 0. 11P ~ (0. 33) P ~ (0. 15) and EDSS score (P ~ (0.05) ~ 0. 05), but no significant difference was found between the two groups (P < 0. 05) and P 0. 05% (P < 0. 05), and no significant difference was found between the two groups (P < 0. 05) and P 0. 05% (P 0. 05) and P 0. 05 (P 0. 05) respectively. Conclusion the apparent normal visual radiation areas in patients with RRMS and RNMO are involved, but the FA values of the two groups have potential application value in differentiating MS from NMO, and can be used as an important biological index to monitor the clinical progress of MS and NMO.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R445.2;R744.5

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