动脉自旋标记技术在视神经脊髓炎中的应用研究  

3.0T MRI Arterial Spin Labeling Technology in Application of Neuromyelitis Optica

作　　者：孙峥[1,3] 段云云 黄靖[1,3] 刘亚欧 任卓琼[1,3] 张甜 刘峥[2] 李坤成 SUN Zheng;DUAN Yunyun;HUANG Jing(Department of Radiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,P. R. China)

机构地区：[1]首都医科大学宣武医院放射科,北京100053 [2]首都医科大学宣武医院神经内科 [3]磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《临床放射学杂志》2018年第11期1775-1779,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金青年项目(编号:81401377);北京市医院管理局临床医学发展专项经费资助(编号:ZYLX201609)

摘　　要：目的应用动脉自旋标记(ASL)技术分析视神经脊髓炎(NMO)患者的脑血流灌注情况,及其与临床指标的相关性。方法对经临床确诊的36例NMO患者(NMO组)和20名性别、年龄匹配的健康志愿者(对照组)行ASL检查,应用MRICRO软件获得14个感兴趣区(ROI)的相对脑血流量(rCBF),ROI包括双侧的尾状核、壳核、丘脑、额叶、顶叶、颞叶、枕叶的脑白质。应用独立样本t检验比较NMO组和对照组的rCBF值差异,应用Pearson相关分析rCBF值与患者临床病程、扩展残疾状态量表(EDSS)以及听觉连续加法测试(PASAT)的相关性。结果NMO患者双侧尾状核的rCBF为(372.03±19.5、352.63±17.79)ml·min^-1·100g^-1,正常对照组为(334.57±32.29、318.47±33.91)ml·min^-1·100g^-1;NMO患者双侧壳核rCBF为(417.66±20.79、403.46±18.07)ml·min^-1·100g^-1,正常对照组为(373.00±18.11、391.77±20.72)ml·min^-1·100g^-1;NMO患者双侧额叶的rCBF为(109.22±24.39、79.80±8.29)ml·min^-1·100g^-1,正常对照组为(85.18±15.65、69.62±12.54)ml·min^-1·100g^-1;与正常对照组相比较,呈现高灌注状态。NMO患者双侧丘脑的rCBF为(467.95±20.36、509.32±24.39)ml·min^-1·100g^-1,正常对照组为(574.28±44.21、584.87±45.85)ml·min^-1·100g^-1;NMO患者双侧顶叶的rCBF为(46.80±5.05、53.94±7.12)ml·min^-1·100g^-1,正常对照组为(55.39±6.91、55.12±10.34)ml·min^-1·100g^-1;NMO患者双侧枕叶的rCBF为(61.76±7.64、50.12±5.69)ml·min^-1·100g^-1,正常对照组为(88.75±9.92、94.75±19.86)ml·min^-1·100g^-1;NMO患者双侧颞叶的rCBF为(184.62±16.26、189.92±17.08)ml·min^-1·100g^-1,正常对照组为(195.93±28.40、187.04±31.21)ml·min^-1·100g^-1;与正常对照组相比较,呈现低灌注状态,其中左侧丘脑、双侧枕叶低灌注具有显著性差异(P<0.05);枕叶低灌注与EDSS呈显著负相关(P<0.05)。结论ASL能检测到NMO患者的脑血流灌注异常,为判断脑区损伤和预后提供有价值的信息。Objective To explore the application of arterial spin labeling ( ASL) for assessing brain perfusion in neuro-myelitis optica ( NMO) patients,and its correlation with clinical indicators. Methods 36 clinically confirmed NMO pa-tients and 20 sex-and,age-matched healthy controls were performed ASL examination. Relative cerebral blood flow( rCBF)of fourteen regions of interest( ROI) ,which were including the bilateral caudate nucleus,putamen,thalamus and white mat-ter in the frontal lobe,parietal lobe,temporal lobe and occipital lobe,were measured by using MRICRO software. Independ-ent sample t-test was used to compare the CBF value between NMO patients and healthy controls,and Pearson correlation a-nalysis was used to assess the correlation between CBF value and clinical course,EDSS,and PASAT. Results The rela-tive cerebral blood volume of caudate of NMO patients was ( 372. 03 ±19. 5,352. 63 ±17. 79) ml·min^-1 ·100g^-1 ,andthe normal control group was ( 334. 57 ±32. 29,318. 47 ±33. 91) ml·min^-1 ·100g^-1 ; The relative cerebral blood volumeof the putamen of NMO patients was ( 417. 66 ±0. 79,403. 46 ±18. 07) ml·min^-1 ·100g^-1 ,and the normal control groupwas ( 373. 00 ±18. 11,391. 77 ±20. 72) ml·min^-1 ·100g^-1 ; The relative cerebral blood volume of frontal lobe of NMOpatients was ( 109. 22 ±24. 39,79. 80 ±8. 29) ml·min^-1 ·100g^-1 ,and the normal control group was ( 85. 18 ± 15. 65,69. 62 ±12. 54) ml·min^-1 ·100g^-1 ; Compared with normal control group,high perfusion status was presented. The rela-tive cerebral blood volume of the thalamus of the NMO patients was ( 467. 95 ± 20. 36,509. 32 ± 24. 39) ml·min^-1 ·100g-1 ,and the normal control group was ( 574. 28 ±44. 21,584. 87 ±45. 85) ml·min -1 ·100g^-1 ; The relative cerebralblood volume of the parietal lobe of the NMO patients was ( 46. 80 ±5. 05,53. 94 ±7. 12) ml·min^-1 ·100g^-1 ,and thenormal control group was ( 55. 39 ±6. 91,55. 12 ±10. 34) ml·min^-1 ·100g^-1 ; The relative cerebral blood volume of theoccipital lobe in

关 键 词：视神经脊髓炎 动脉自旋标记 脑灌注血流量 

分 类 号：R744.52[医药卫生—神经病学与精神病学]