单体型特纳综合征患儿全脑灰、白质基于体素的形态学分析  

A whole-brain gray and white matter analysis in children with 45XO karyotype Turner syndrome： voxel-based morphometry

作　　者：赵秋玲[1] 谢晟[2] 张知新[1] 潘慧[3] 李康[3] 张嘉颖[4] 程盼贵[1] 龚高浪[4] 刘茜玮[2] 

机构地区：[1]中日友好医院儿科,北京100029 [2]中日友好医院放射科,北京100029 [3]中国医学科学院北京协和医院儿科 [4]北京师范大学认知神经科学与学习国家重点实验室

出　　处：《中华放射学杂志》2013年第5期421-425,共5页Chinese Journal of Radiology

基　　金：北京师范大学认知神经科学与学习国家重点实验室开放课题资助项目（20120206）

摘　　要：目的利用基于体素的形态测量学（VBM）方法，探测单体型特纳综合征（TS）患儿脑灰、白质体积的异常。方法选取9例染色体核型为45XO的单体型TS患儿（TS组）和20名正常女童（对照组），进行了韦氏智力测量和3．0TMR扫描。TS组和对照组的全脑高分辨率T1WI采用统计参数图sPM8软件包进行VBM分析，以全脑灰、白质总体积为协变量，以协方差分析比较单体型TS患儿和对照组之间全脑灰、白质体积的差别，采用功能神经图像分析软件包（AFNI）中的蒙特卡洛模拟方法（即A1phasim方法）进行簇水平上的多重比较校正。结果TS组患儿韦氏总智商值为81±13，而对照组儿童韦氏总智商值为109±16，两组儿童智商差异具有统计学意义（t=4．70，P〈0．05）。与对照组比较，单体型TS患儿右侧顶上小叶、中央后回、楔叶、楔前叶、距状皮层，左侧枕叶中下部灰质体积减小，差异有统计学意义（统计区体素数目分别为631、525、520个，t值分别为3．95、3．50、3．36，P值均〈0．05）；双侧辅助运动区、额上回内侧，右侧扣带回中部，左侧颞上、中、下回，左侧额上、中、下回，左侧小脑，左侧海马、海马旁回，左侧梭状回灰质体积增加，差异有统计学意义（统计区体素数目分别为2082、974、1708、588、579个，t值分别为5．45、4．59、4．40、4．29、3．55，P值均〈0．05）。白质体积比较的结果表明，单体型TS患儿左侧中央后回及顶下小叶的白质体积较对照组减小，差异具有统计学意义（体素数目957，t=5．85，P〈0．05）。结论TS患儿存在脑灰、白质发育的异常，该异常改变可能是单体型TS患儿认知功能障碍的神经病理学基础。Objective To detect the structural changes of cerebral gray and white matter in children of monosomy Turner syndrome （TS） by using voxel-based morphometry （ VBM ）. Methods Nine children 45XO karyotype TS and 20 age-matched control girls were recruited in this study. Wechsler intelligence scale for children was used to obtain their intelligence quotients （IQ）. High-resolution magnetic MR imaging was performed in TS children and control girls to collect the whole brain structural data. The data were analyzed by VBM based on SPM 8 to compare the volume of gray and white matter between the TS children and normal controls by using eovariance analysis. Results The IQ of TS children was 81 ± 13, and the IQ of the controls was 109 ± 16. Statistical analysis revealed significant difference of IQ between the two groups （ t = - 4. 70, P 〈 0. 05 ） . Compared with normal controls, TS children showed significantly decreased volume （ numbers of voxel in clusters were 631,525,520, t = 3.95,3.50,3.36, P 〈 0. 05, FWE-correeted） in the gray matter of the right superior parietal lobule, postcentral gyrus, precuneus lobule, calcarine, cuneus cortices, as well as the left middle and inferior occipital lobe. However, the volume of the bilateral supplemental motor area and the medial superior frontal lobes, the right middle cingulum, the left superior,middle ,and inferior temporal gyri were increased in the TS children compared to the controls. The left ftlsiform,the left parahippocampus, the left hippocampus and the left cerebellum were also enlarged in TS children （ numbers of voxel in clusters were 2082,974,1708,588,579, t = 5.45,4.59,4.40,4. 29,3.55, P 〈 0. 05, FWE-corrected ）. White matter regions in the left postcentral gyrus and inferior parietal lobule showed significantly reduced volume （ voxel number 957, t = 5.85, P 〈 0. 05, FWE-corrected）. Conclusion Children with monosomy TS show abnormal gray and white matter volumes in some brain regions ,which may be involved in the neuropathology of

关 键 词：特纳综合征 磁共振成像 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学]