丘脑1H磁共振波谱成像在强迫症中的应用  

Thalamus in Patients with Obsessive--Compulsive Disorder：ill Magnetic Resonance Spectroscopy Study

作　　者：尤超[1] 谭令[1] 范青[2] 丁蓓[1] 肖泽萍[2] 陈克敏[1] 

机构地区：[1]上海交通大学医学院瑞金医院放射科,上海200025 [2]上海交通大学医学院精神卫生中心,上海200025

出　　处：《实用放射学杂志》2011年第2期161-165,共5页Journal of Practical Radiology

基　　金：基金项目：上海市重点学科建设资助项目（编号：S30203）;上海市市级医院新兴前沿技术联合攻关项目（编号：SHDC12006105）;国家高技术研究发展计划（863计划）（编号：2007AA022420）;上海市科委重点科技攻关项目（编号：074119520）.

摘　　要：目的基于强迫症前额叶-纹状体-丘脑环路障碍假说，采用磁共振波谱成像（1H—MRS）研究成人强迫症（OCD）患者舣侧丘脯1H—MRS表现及其与临床症状的关系。方法13例经临床确诊的强迫症患者和与之相匹配的14例健康志愿者，分别行1．5TMRI的MRS检查，采用单体素点回波成像序列，采集双侧丘脑的波谱图像。所获图像经Sage软件后处理相应代谢指标N-乙酰灭门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、肌醇（mI），测量NAA／Cr，Cho／Cr，mI／Cr峰高相对值；并分析上述各值与OCD患者临床评分及病程时间的相关性。结果与健康对照相比，OCD患者双侧丘脑的mI／Cr、NAA／Cr明显降低，具有显著统计学差异；并且右侧丘脑NAA／Cr与强迫症病程时间呈负相关（r=0．963，P〈0．001）。结论OCD患者双侧丘脑NAA及mI代谢物含量降低，1H—MRS可反映OCD患者丘脑代谢物的变化特征，并且可以证实OCD前额叶-纹状体-丘脑环路障碍的假说。Objective On the basis of the hypothesis that patients with obsessive--compulsive disorder（OCD） have dysfunction of fronto--striato--thalamoeortical circuitry, to study the metabolism change in the bilateral thalamic region with 1H magnetic reso- nance spectroscopy （ 1 H- MRS） and its correlations with clinical scale. Methods 13 patients with OCD and 14 matched healthy vol- unteers were enrolled in this study. Single voxel proton magnetic resonance spectroscopy was used to examine the bilateral thalamus for each subject. N--acetylaspartate（NAA）, creatine（Cr） , choline（Cho） and myo- inositol（mI） value of bilateral thalamus were acquired by using Sage software. Then the relativity of the MRS results and clinical scale were analyzed. Results A significant reduction in NAA/Cr and mI/Cr were observed in bilateral thalamus, and NAA/Cr of right thalamu was negative correlated with the course of OCD（r= --0. 963,P〈0. 001）. Conclusion Neuronal loss and NAA and mI decreased can be detected by using proton MRS in OCD patients. 1H--MRS is an useful tool in reflecting the characteristic changes of metabolism in OCD, and support the hypothesis of fronto--striato--thalamocortical circuitry.

关 键 词：强迫症 磁共振波谱 丘脑 前额叶-纹状体-丘脑环路 

分 类 号：R749.7[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]