肌萎缩侧索硬化症的磁共振弥散张量成像研究  

A study on MR diffusion tensor imaging of amyotrophic lateral sclerosis

作　　者：侯晓妹[1] 杨碧莹[1] 张旭祥[2] 杜宝新[1] 王家伟[2] 唐梅丽[3] 郑瑜[1] 

机构地区：[1]广东省中医院神经科,510006 [2]广州中医药大学,2012级硕士研究生510405 [3]广东省中医院影像科,510006

出　　处：《中国神经免疫学和神经病学杂志》2015年第5期330-333,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：广东省科技计划项目(2010B030700027);广东省中医药局资助项目(2010139)

摘　　要：目的初步探讨磁共振弥散张量成像(DTI)在肌萎缩侧索硬化(ALS)诊断中的应用价值。方法选取54例具有不同诊断级别的ALS患者,包括确诊(21例)、很可能(22例)、可能(11例)的患者,同时选取23名健康体检的志愿者作为健康对照。分别行DTI扫描,测量各感兴趣区(ROI)的平均扩散系数(ADC)和各向异性系数(FA),分析两组间ADC和FA的差异,并对ALS组患者ADC值及FA值与临床资料的相关性进行分析。结果与健康对照组比较,ALS患者大脑脚、内囊后肢区的ADC值升高(P<0.01),大脑脚、内囊后肢及中央前回区的FA值降低(P<0.01);相关分析显示ALS患者内囊后肢的ADC值与诊断级别呈负相关(r=-0.289,P<0.05),与上运动神经元损伤评分呈正相关(r=0.304,P<0.05);大脑脚及内囊后肢的FA值与诊断级别呈正相关(r=0.394,P<0.01;r=0.547,P<0.01),与上运动神经元损伤评分呈负相关(r=-0.301,P<0.05;r=-0.653,P<0.01).结论 DTI可客观定量评估ALS患者锥体束的损伤情况,在ALS的诊断中具有重要的辅助价值。Objective To investigate the value of diffusion tensor imaging （DTI） for the diagnosis of amyotrophic lateral sclerosis （AIRS）. Methods Fifty-four cases of ALS patients with different diagnostic levels were selected, including clinically definite （21 cases）, clinically probable （22 cases）, clinically possible （11 cases） . At the same time, 23 healthy volunteers were recruited as controls. Fractional anisotropy （FA） and average diffusion coefficient （ADC） values were measured in each region of interest respectively. The difference of diffusion parameters between the two groups were analyzed and the correlations between diffusion parameters and various clinical variables were investigated by Spearman correlation analysis. Results Compared with healthy controls, a significant increase in ADC were found （P〈O. 01） on the level of posterior limb of internal capsule and the cerebral peduncle in ALS group. A significant reduction in FA were found （P〈0.01） on all the levels of region of interest in ALS group. The ADC values in the posterior limb of internal capsule level correlated negatively with diagnostic levels of the patients （r=-0. 289, P〈0.05）, and correlated positively with upper motor neuron injury score （r= 0. 304, P〈0.05）. The FA values in the cerebral peduncle level and posterior limb of internal capsule level correlated positively with the diagnostic levels （r= 0. 394, P〈0. 01; r= 0. 547, P〈 0.01）, and correlated negatively with upper motor neuron injury score （r=- 0. 301, P〈0.05; r=- 0. 653, P〈0.01）. Conclusions DTI can objectively evaluate the impairment of pyramidal tracts in ALS patients and can be used as an important adjuvant measure for the diagnosis of ALS.

关 键 词：肌萎缩侧索硬化 弥散张量成像 锥体束 

分 类 号：R744.8[医药卫生—神经病学与精神病学]