DKI联合DWI对不同程度慢性高原病大脑灰白质的研究

发布时间：2018-05-18 01:12

本文选题：慢性高原病 + 扩散峰度成像　；参考：《青海大学》2017年硕士论文

【摘要】：目的:采用3.0 T高场磁共振的功能成像序列中的扩散峰度及扩散加权成像技术,探究在高海拔低氧环境下不同程度慢性高原病患者脑白质及深部灰质核团微结构的变化。方法:选取临床已确诊为慢性高原病的患者,并按病情分轻度、中度、重度三组,每组各10例,正常对照组(高海拔地区正常成年人)10例,均进行磁共振常规头部序列、DWI及DKI序列,分别用后处理软件重构出MK、RK、A K及ADC图,并在测量软件的轴位图上镜像对称固定选取半卵圆中心、额叶及枕叶白质、内囊结构、纹状体、丘脑、胼胝体膝部及压部为感兴趣区,测量各感兴趣区的参数值,对各组间同一部位感兴趣区参数值进行分析比较。结果:1、三种CMS组与正常对照组相比,大脑半球的深部灰质核团及白质纤维区域的三项扩散参数值及ADC值的差异性随着病情加重而逐渐明显。重度CMS组的两侧额叶白质及左侧尾状核头的MK值、胼胝体膝部及压部的RK值均较轻度CMS组低(P0.05);胼胝体膝部及压部的MK值及RK值,两侧的半卵圆中心、两侧额叶及枕叶白质、两侧尾状核头及右侧丘脑的MK值,右侧内囊前肢RK值,左侧尾状核头和右侧额叶白质的AK值较正常组均有不同程度的减低(P0.05)。2、三种CMS组及正常对照组的左右两侧大脑半球参数值相比,正常对照组的右侧半卵圆中心AK值、尾状核头RK值、额叶白质MK值、枕叶MK及ADC值、内囊前肢及丘脑的MK及RK值较左侧高(P0.05);轻度CMS组右侧半卵圆中心ADC值、尾状核头RK值较左侧高(P0.05);中度CMS组的右侧枕叶白质、内囊前肢及后肢AK值、尾状核头RK值较左侧高(P0.05);重度组右侧半卵圆中心及枕叶白质ADC值较左侧高(P0.05)。结论:随着CMS病情程度的进展,部分大脑灰白质区扩散参数值在CMS患者与正常高原人之间差异愈加明显,推测在长期高原低压缺氧环境会可引起可逆或不可逆性脑损伤,而致使CMS患者脑组织微结构发生改变。
[Abstract]:Objective: To explore the changes in the microstructure of white matter and deep gray matter nuclei in the brain of patients with different degrees of high altitude and hypoxia in high altitude hypoxia environment by using the diffusion kurtosis and diffusion weighted imaging technique in the 3 T high field magnetic resonance imaging sequence. In the severe three groups, 10 cases in each group and 10 cases in the normal control group (normal adults in high altitude area), the general head sequence, DWI and DKI sequence were performed by magnetic resonance, and the MK, RK, A K and ADC were reconstructed with the post-processing software, and the center of the oval circle, the white matter of the frontal and occipital lobe, the structure of the inner capsule, and the grain were fixed on the axis bitmap of the measuring software. The body, thalamus, the genu of the corpus callosum and the pressure part were the region of interest, measured the parameters of each region of interest, and compared the parameters of the region of interest in the same parts of each group. Results: 1, the difference between the three diffusion parameters and the ADC value of the deep gray matter nucleus and the white matter fiber region of the cerebral hemisphere was compared with the normal control group. The 1 groups were compared with the normal control group. The MK value of the bilateral frontal lobes and the left caudate nucleus, the RK value of the genu and pressure part of the corpus callosum in the severe CMS group were lower than those in the mild CMS group (P0.05), the MK value and RK value of the genu and pressure part of the corpus callosum, the center of the bilateral oval circles, the white matter of the bilateral frontal and occipital lobes, the MK of the bilateral caudate nucleus and right thalamus, right, right The RK value of the forelimb of the lateral internal capsule, the AK value of the left caudate nucleus and the right frontal lobar white matter were lower than the normal group (P0.05).2. Compared with the left and right hemisphere parameters of the left and right sides of the three CMS groups and the normal control group, the AK value of the right hemispherical center in the normal control group, the RK value of the caudate nucleus, the MK value of the frontal white matter, the value of the MK and ADC of the occipital lobe, and the front of the inner capsule. The value of MK and RK in the limb and thalamus was higher than that in the left side (P0.05), the ADC value of the right semi oval center in the mild CMS group and the higher RK value of the caudate nucleus were higher than that on the left (P0.05); the right occipital lobe white matter in the moderate CMS group, the AK value of the anterior and hind limbs of the inner capsule, and the higher value of the RK value of the caudate nucleus were higher than that on the left side (P0.05); the right semi oval center and the occipital white matter ADC value of the severe group was higher than that in the left. Conclusion: With the progress of the degree of CMS, the difference between the diffusion parameters of part of the gray white matter region of the brain is more obvious between the CMS patients and the normal plateau people. It is speculated that the long-term high altitude hypoxia environment can cause reversible or irreversible brain damage, which leads to the changes in the microstructure of the brain tissue of the patients with CMS.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R594.3

【相似文献】