联合应用VBA和TBSS方法检测复发缓解型多发性硬化患者脑损害

发布时间：2019-01-15 20:46

【摘要】：目的联合应用基于体素分析(VBA)和基于纤维束示踪的空间统计分析(TBSS)方法检测复发缓解型多发性硬化(RRMS)患者全脑灰白质体积和白质纤维束的改变。方法选取RRMS患者及健康对照者各20例进行3D-T1WI、扩散张量成像(DTI)的数据采集,应用VBA方法比较两组全脑灰质和白质萎缩区域,应用TBSS方法比较两组全脑白质纤维的部分各向异性(FA)值的差异,寻找VBA和TBSS分析法均显示异常的区域。结果与正常对照组相比,RRMS患者灰质萎缩主要在双侧丘脑、双侧尾状核头部、双侧海马、双侧岛叶、右侧壳核、双侧额上回、额中回、左侧颞中回、左侧顶叶;白质萎缩主要为胼胝体、双侧额上回、左侧额中回、左侧颞下回、右侧颞中回、右侧枕叶、双侧顶叶、左侧桥臂。FA值下降的纤维束主要为双侧小脑上脚、小脑下脚、右侧小脑中脚、皮质脊髓束、内侧丘系、扣带束、穹窿束、双侧丘脑上辐射、丘脑后辐射、胼胝体、双侧钩束、下纵束、上纵束、上枕-额束、双侧胼胝体/下枕-额束、下枕-额束/下纵束。RRMS患者双侧额颞顶叶、海马、扣带回、岛叶、丘脑、胼胝体等区域既有萎缩也存在FA值的下降。结论 RRMS患者存在多发的灰白质萎缩区域和白质纤维的损害,RRMS患者双侧额颞顶叶、海马、扣带回、岛叶、丘脑、胼胝体等区域白质纤维的损害可能是脑萎缩的病理基础。
[Abstract]:Objective to detect the changes of white matter volume and white matter fiber bundle in the whole brain of patients with relapsed multiple sclerosis (RRMS) by combined use of voxel analysis (VBA) and spatial statistical analysis (TBSS) based on tracer tracing. Methods 20 patients with RRMS and 20 healthy controls were selected to collect the data of 3D-T1WI and diffusion-Zhang Liang imaging (DTI). The gray matter and white matter atrophy areas of the whole brain were compared by VBA method. TBSS method was used to compare the difference of partial anisotropic (FA) values of white matter fibers between the two groups, and to find the areas in which both VBA and TBSS analysis showed abnormal. Results compared with the control group, the gray matter atrophy in RRMS patients was mainly in bilateral thalamus, bilateral caudate nucleus head, bilateral hippocampus, bilateral island lobe, right putamen nucleus, bilateral superior frontal gyrus, middle frontal gyrus, left middle temporal gyrus and left parietal lobe. The white matter atrophy was mainly corpus callosum, bilateral superior frontal gyrus, left middle frontal gyrus, left inferior temporal gyrus, right middle temporal gyrus, right occipital lobe, bilateral parietal lobe, left pontine arm. Right middle cerebellar foot, corticospinal tract, medial colliculus, cingulate tract, fornix tract, bilateral suprathalamic radiation, retrothalamic radiation, corpus callosum, bilateral hook bundle, inferior longitudinal tract, superior occipito-frontal tract, bilateral corpus callosum / occipital-frontal tract, The bilateral frontotemporal parietal lobe, hippocampus, cingulate gyrus, insular lobe, thalamus and corpus callosum in patients with RRMS had both atrophy and decreased FA. Conclusion there are multiple lesions of gray matter atrophy and white matter fibers in RRMS patients. The lesions of bilateral frontotemporal parietal lobe, hippocampus, cingulate gyrus, insular lobe, thalamus and corpus callosum may be the pathological basis of cerebral atrophy in RRMS patients.
【作者单位】：贵阳医学院附属医院影像科;湖南省邵阳市中心医院放射科;贵阳医学院附属医院神经内科;贵阳医学院附属医院病理科;
【基金】：教育部长江学者和创新团队发展计划资助项目(编号:IRT13058) 贵阳医学院附属医院资助项目(I-2012-1)
【分类号】：R445.2;R743

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