围产期HIV感染无症状青少年脑部体素内不相干运动扩散加权成像研究  

Study on the Brains of Perinatally HIV Infected Asymptomatic Adolescents by Intravoxel Incoherent Motion Diffusion Weighted Imaging

作　　者：张静[1] 王科[1] 李洁兰[1] 文之[1] 杨昊[1] 周洁[2] 吴光耀[1] 

机构地区：[1]武汉大学中南医院MRI室,湖北武汉430071 [2]武汉大学中南医院干部保健处,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2016年第3期451-456,共6页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81171315;81227902)

摘　　要：目的:探讨基于体素内不相干运动扩散加权成像(IVIM-DWI)研究围产期HIV感染无症状型青少年脑扩散与灌注信息可行性及其变化特征。方法:收集临床确诊围产期HIV感染无症状青少年18例(HIV^+组)和来自艾滋病家庭年龄、性别匹配HIV阴性对照组(HIV-组)17例。受试者均行常规MR脑平扫和IVIM-DWI检查。IVIM-DWI选取7个b值,经MITK软件拟合和MRICroN软件测量获得双侧尾状核和额叶白质IVIM参数值的平均值(D值、D*值和f值)。独立样本t检验、Pearson相关性分析IVIM参数值与CD4^+T淋巴细胞计数、CD4/CD8比值的相关性。结果:与对照组比较,HIV^+组尾状核和额叶白质灌注扩散系数D*值有显著降低(P<0.01);D*值与CD4^+T淋巴细胞计数、CD4/CD8比值呈显著正相关(尾状核r分别为0.719和0.640;额叶白质r分别为0.440和0.546;P<0.05)。HIV^+组尾状核和额叶白质D值和f值差异无统计学意义,与CD4^+T淋巴细胞计数、CD4/CD8比值无显著相关性。结论:IVIM-DWI能敏感检测围产期HIV感染无症状型青少年尾状核和额叶白质微循环灌注不相干运动D*值的变化,D*值可能作为HIV感染脑部变化早期和进展评估的可视化标志物。Objective：To explore the Intravoxel Incoherent Motion diffusion-weighted imaging（IVIMDWI）feasibility and change in the brain of adolescent with perinatal HIV infection.Methods：We collected eighteen children with perinatally HIV infection（HIV~＋group）and seventeen HIV negative children matched aged and gender as control group.All subjects were examined on the brain by a 3.0T MR scanner using conventional cerebral sequences and IVIM-DWI（Seven b values）.IVIM parameter values（D,D＊and f value）could be got by fitting MITK software and measuring MRICroN software,while mean values were from bilateral caudate nucleus and frontal white matter.Correlation of independent sample t-test and Pearson correlation analysis between D,D＊,f values and CD4~＋T lymphocytes counts and CD4/CD8 Tlymphocytes were analyzed.Results：Compared with HIV-group,D＊values of caudate nucleus and frontal white matter in HIV~＋group significantly decreased（P0.01）;D＊values with CD4~＋count and CD4/CD8 were significantly positively correlated（r of caudate nuclear：0.719 and 0.640;r of frontal white：0.440and0.546;P0.05）.D and f values of caudate nucleus and frontal white matter showed no statistically difference,there was no significant correlation between D and f values to CD4~＋count and CD4/CD8.Conclusion：IVIM-DWI can sensitively detect cerebral D＊changes related microcirculation incoherent motion in caudate nucleus and frontal white matter of perinatal HIV infection asymptomatic adolescents,and D＊value is a potential visual biomarker in estimating the HIV~＋cerebral early change and progress.

关 键 词：围产期 青少年 HIV感染 体素内不相关运动 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]