青年抑郁症患者脑的3D ^1H MRS和DTI应用研究  

Study of cerebra in youth major depression detected with three-dimension hydrogen proton magnetic resonance spectroscopy and diffusion tensor imaging

作　　者：林明方[1] 李建军[2] 王桂华[2] 蒋湘玲[1] 郭敏[1] 廖光锐[1] 李传资[2] 

机构地区：[1]海南省人民医院心理咨询与治疗中心,海口570311 [2]海南省人民医院放射科,海口570311

出　　处：《中华临床医师杂志（电子版）》2009年第6期39-44,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨抑郁症患者脑内可能存在的神经生化代谢异常和细微结构改变。方法对54例首发青年抑郁症患者应用三维磁共振氢质子波谱(3D 1H MRS)检查,测量脑内多个部位的N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)、肌醇(mI)和肌酸(Cr)等代谢物含量的绝对值,并计算NAA、Cho、mI与Cr的比值。同时进行扩散张量成像(DTI)的表观扩散系数(ADC)和各向异性分数(FA)的检测,并与50名健康对照者作比较。结果(1)抑郁症患者的前额叶扣带回皮质、豆状核和尾状核头部的Cho、mI绝对值及Cho/Cr、mI/Cr比值明显高于健康对照组(P均<0.05);(2)抑郁症组的额叶白质、胼胝体膝部和体部的ADC值明显高于健康对照组,FA值明显低于健康对照组(P<0.01)。(3)3D 1H MRS、DTI单独检测的敏感性分别为88.9%、79.6%,两者联合应用敏感性达92.6%。结论青年抑郁症患者脑内可能存在多个部位的微细结构和神经生化改变,3D 1H MRS和DTI检测指标可考虑作为抑郁症的客观参考诊断标准之一。Objective This study examined the minute nerve tissue and neurochemical abnormalities in youth major depression by using three-dimension hydrogen proton magnetic resonance spectroscopy（3D ^1H MRS）and diffusion tensor imaging （DTI） . Methods Fifty-four patients with major depression and fifty comparison subjects similar in age and gender to the patients were scanned on a 1.5-T magnetic resonance scanner with head coil. In the bilaterally multiple locations of the cerebra, the absolute levels of N-acetylaspartate （ NAA）, choline （ Cho）, myo-inositol （mI） and creatine （Cr） were measured, and their ratios of metabolite to Cr levels were computed from the absolute values, and then, the apparent diffusion coefficients（ADCs） and fractional antisotropys（FAs） were measured. Results （1） The absolute values of Cho and mI, Cho/Cr and mI/Cr ratios were significantly higher in the bilateral cingulate gyrus gray,lentiform nucleus and the head of caudate nucleus in the major depression group than that in normal control group, P 〈 0. 05;（2）The values of ADC in the frontal lobe, genu and body of the corpus callosum were significantly higher than that in the comparison group （P 〈0. 01 ） ,while the ratios of the FA were lower than that in the comparison group（ P 〈 0. 01 ） ; （ 3 ） The sensitivity of 313 ^1H MRS and DTI to young major depression was 88.9% and 79.6 % respectively, and the combined measurement sensitivity reached 92.6%. Conclusions It is possible that there are multiple locations minute nerve structure and neurochemical changes in major depressions cerebra, and 3D ^1H MRS and DTI may provide some objective substrates to young major depression.

关 键 词：抑郁症 磁共振波谱学 磁共振成像 弥散 大脑 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R978.5[医药卫生—临床医学]