丘脑梗死患者海马结构和功能异常的MRI研究  

MRI Study of Structural and Functional Change of Hippocampus in Patients with Thalamic Infarction

作　　者：陈莉[1,2] 吕发金[2] 罗天友[2] 史丹丹[2] 蔡昌平[1] 李琦[2] 张志伟[2] 

机构地区：[1]川北医学院基础医学院解剖教研室,南充637000 [2]重庆医科大学附属第一医院放射科,400016

出　　处：《临床放射学杂志》2015年第9期1378-1382,共5页Journal of Clinical Radiology

基　　金：国家临床重点专科建设项目经费资助(国卫办医函[2013]54号)

摘　　要：目的探讨丘脑梗死后记忆功能减退患者海马的结构和功能改变情况,初步揭示其记忆功能减退的神经影像学机制。方法选取23例慢性丘脑梗死患者(TI组)和性别、年龄及受教育年限与之相匹配的健康志愿者28名(对照组),对所有受试者进行神经心理学评估、MRI全脑高分辨率解剖成像和静息态f MRI扫描。运用Freesuefer V.5.3软件进行海马分割及体积计算,采用DPARSF、SPM 8软件进行静息态f MRI数据预处理、ALFF值计算及统计分析。结果 (1)TI组MMSE评分(P=0.000)、词语短延迟回忆(P=0.001)、长延迟回忆(P=0.000)、再认(P=0.000)、复杂图形回忆(P=0.000)及数字倒背(P=0.006)分数均显著低于对照组;(2)TI组的病灶侧海马体积显著小于对照组(P=0.002),健侧海马体积与对照组比较无统计学差异(P=0.537);(3)与对照组比较,TI组患者的病灶侧海马ALFF值增加。结论丘脑梗死患者记忆功能减退可能是病灶侧海马体积萎缩所致,海马功能活动增强可能为代偿作用。Objective To investigate the structural and functional changes of hippocampus with memory hypofunction after thalamic infarction（ TI）,and to preliminarily reveal the mechanism of neuroimaging. Methods A total of twenty three TI patients（ TI group） and twenty eight sex,age,as well as education matched healthy controls（ control group） were enrolled in the present study. MR imaging was performed at a 3. 0T MR scanner. Clinical examinations（ MMSE and memory tests） were performed for all subjects. Volume of hippocampus on MR images was automatically estimated using FreeSurfer software. Preprocessing of rest f MRI data was conducted with the software of SPM8 and DPARSF. Using GLM with gender,age,education years and intracranial volume as the nuisance covariates to analyze the two sample t test,comparison in the difference of ALFF between TI group and control group was done. Results（ 1） There were significant difference in MMSE（ P = 0. 000）,short delayed recall（ P = 0. 001）,long delayed recall（ P = 0. 000）,recognition（ P =0. 000）,complex graphics recall（ P = 0. 000） and digit backwards（ P = 0. 006） between the TI patients and controls.（ 2） TI group had decreased ipsilesional hippocampus volume（ P = 0. 002） when compared with healthy control group,but there was no significant difference in contralesional hippocampus between TI patients and control group（ P = 0. 537）.（ 3）Compared to healthy subjects,TI group demonstrate a significantly increased ALFF in ipsilesional hippocampus. Conclusion Atrophy of ipsilesional hippocampus might cause memory impairment in thalamus infarction patients,and enhanced hippocampal function activity might play a compensatory role.

关 键 词：丘脑梗死 记忆 海马 低频振幅 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]