磁共振扩散张量成像观察偏执型精神分裂症患者双侧钩束损伤  

Magnetic resonance diffusion tensor imaging study of damage of bilateral uncinate fasciculus in patients with paranoid schizophrenia

作　　者：王宏磊[1] 邬海博[1] 袁慧书[1] 刘毅[1] 阎浩[2] 

机构地区：[1]北京大学第三医院放射科,北京100191 [2]北京大学精神卫生研究所,北京100191

出　　处：《中国医学影像技术》2012年第3期439-443,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用DTI评价偏执型精神分裂症(SP)患者双侧钩束的损伤情况,探讨其与临床症状等指标之间的关系。方法对33例偏执型SP患者(SP组)和30名正常人(对照组)行脑部DTI扫描,测量双侧钩束的FA值和平均弥散率(MD)值,对同侧DTI指数进行组间比较,并对患者两侧钩束的DTI指数进行组内比较及不对称性分析,其中不对称性分析采用不对称系数(AI)进行计算,并统计分析,最后对SP患者双侧钩束的DTI指数与阳性和阴性症状量表(PANSS)评分进行相关性检验。结果偏执型SP者左右侧钩束的FA值分别为0.65±0.31和0.55±0.12,MD值为(0.75±0.04)×10-3mm2/s和(0.75±0.04)×10-3mm2/s;对照组FA值分别为0.66±0.09和0.65±0.07,MD值为(0.75±0.04)×10-3mm2/s和(0.75±0.05)×10-3mm2/s。SP患者双侧FA值均有明显下降(P<0.05),且FA值与PANSS的阴性症状得分(rL=0.36,P<0.05;rR=0.35,P<0.05)、一般病理症状得分(rL=0.35,P<0.05;rR=0.39,P<0.05)及总分(rL=0.40,P<0.05;rR=0.41,P<0.05)均呈正相关,而与PANSS阳性症状得分无明显相关性(P>0.05)。SP组与对照组同侧钩束MD值及SP组双侧钩束FA值差异均无统计学意义(P>0.05),且SP患者钩束不存在显著左右不对称性(P>0.05)。结论DTI能发现偏执型SP患者双侧钩束纤维微观结构的损害以及两侧不对称性的缺失,并且这些损害与临床症状及病情严重程度相关。Objective To evaluate the damage of bilateral uncinate fasciculuses in patients with paranoid schizophrenia（SP） using diffusion tensor imaging（DTI）,and to explore the relationship between the damage and clinical data.Methods Thirty-three patients with paranoid SP（SP group） and 30 normal controls（control group） underwent MR DTI.FA and mean diffusivity（MD） values of uncinate fasciculuses in two groups were measured,respectively.The differences of DTI indices of bilateral uncinate fasciculuses were compared between two groups,and bilateral uncinate fasciculuses of SP patients within group comparisons were made,while asymmetry analysis was used to analyze bilateral uncinate fasciculuses in patients with asymmetry index（AI）.The correlation between DTI indices and the positive and negative syndrome scale（PANSS） scores were analyzed.Results FA value of uncinate fasciculus in SP group was 0.65±0.31（left） and 0.55±0.12（right）,while the MD value was（0.75±0.04）×10-3 mm2/s（left） and（0.75±0.04）×10-3 mm2/s（right）,respectively.FA value of fasciculus in control group was 0.66±0.09（left） and 0.65±0.07（right）,while the MD value was（0.75±0.04）×10-3 mm2/s（left） and（0.75±0.05）×10-3 mm2/s（right）,respectively.FA values of uncinate fasciculuses decreased obviously in SP group than that in control group（P〈0.05）,and there was statistical correlation between FA values and the PANSS-N（rL=0.36,P〈0.05;rR=0.35,P〈0.05）,PANSS-G（rL=0.35,P〈0.05;rR=0.39,P〈0.05）,PANSS total scores（rL=0.40,P〈0.05;rR=0.41,P〈0.05）.PANSS-P showed no correlation with FA values of uncinate fasciculuses in SP group（P〉0.05）.There was no statistical difference between MD values nor bilateral uncinate fasciculuses in SP group（P〉0.05）.The asymmetry was non-existent in uncinate fasciculuses of patients（P〉0.05）.Conclusion The absence of left-right asymmetry and the damage of microstructures in uncinate fasciculuses of the paranoid SP patients ca

关 键 词：精神分裂症 扩散磁共振成像 钩束 

分 类 号：R749.8[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]