脑室旁白质软化症患儿脑性视觉损伤的fMRI和DTI研究  

Combination of fMRI and DTI in the Assessment of Cortical Visual Impairment in the Children with Periventricular Leukomalacia

作　　者：刘娜[1] 范国光[1] 于兵[2] 李松柏[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《中国医学影像学杂志》2009年第6期401-405,共5页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金(编号30770630);教育部博士点基金(编号200801590012)资助

摘　　要：目的:探讨联合应用fMRI和DTI评价PVL患儿的脑性视觉损伤的价值。材料和方法:选取24名PVL患儿及24名无窒息史的健康儿童志愿者进行镇静的状态下fMRI及DTI检查,视觉刺激采用2HZ闪烁光,fMRI数据采用SPM2软件进行后处理(ROI),计算患儿组与对照组的激活像素数目。DTI数据采用MedINRIA软件进行后处理,根据矢量元素和部分各向异性值(FA值)生成彩色弥散张量图(DTI图),计算患儿与对照组视觉相关主要白质纤维束的FA值。将视觉激活图与彩色弥散张量图融合。结果:正常对照组的激活区位于初级视觉皮层,PVL患儿的激活区部分移位。PVL患儿枕叶平均激活像素数目较正常对照显著减少,视觉相关主要白质纤维束FA值较正常对照显著降低。PVL患儿视觉区激活像素数目与视觉相关主要白质纤维束FA值呈正相关。结论:联合应用BOLD-fMRI和DTI在评价缺氧缺血性脑损伤后视觉功能变化方面有较高的应用价值。Purpose： To investigate fMRI and DTI in the assessment of cortical visual impairment in children with periventricular leukomalacia （PVL）. Materials and Methods： Twenty-four children with PVL were enrolled. Meanwhile,24 age-matched normal controls were recruited for comparison, fMRI scan was performed using a 3.0T MR scanner. Data analysis was performed by statistical parametric mapping software （SPM2）. Activated voxels were identified in both groups, t test was used for statistical analysis. DTI was performed by MedlNRIA software and DTI color maps were created from fractional anisotropy （FA） values and the three vector elements, FA values on diffusion tensor color maps were compared between the patients and the controls. All the FA values of these WM fibers were analyzed by paired t test. The correlation was calculated between FA values and activated voxels of visual cortex for PVL children using SPSS10. 0. Results： In all 24 norreal children, the maximum response of blood oxygen level-dependent （BOLD） signal was located in the primary visual cortex （PVC）. However, some of the 24 cases of PVL had deviated activation. The active voxels of patients in visual cortex were less than that of controls. All 24 cases of PVL showed a significant mean FA reduction in ICPL and PTR in comparison to the ipsilateral regions of healthy controls. The significantly positive correlation was shown between FA values and activated voxels of visual cortex for PVL children. Conclusion： fMRI and DTI play an important role in the assessment of cortical visual impairment in children with PVL.

关 键 词：脑室旁白质软化 磁共振功能成像 脑性视 觉损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]