基于体素的形态学分析研究皮层下脑梗死患者脑结构的改变  

A voxel-based morphometry study in the evaluation of brain structural alterations in chronic subcortical stroke patients

作　　者：苗培芳 程敬亮[1] 王彩鸿 李鹏[1] 

机构地区：[1]郑州大学第一附属医院磁共振室,河南郑州450052

出　　处：《实用放射学杂志》2016年第6期841-844,共4页Journal of Practical Radiology

摘　　要：目的 利用基于体素的形态学分析（VBM） 研究慢性期缺血性脑梗死患者脑结构可塑性及其与认知功能之间的关系。方法 采用3.0T MR对29例运动功能恢复良好的慢性期皮层下脑梗死患者及30例健康志愿者行全脑高分辨3D-T1WI扫描。采用以统计参数图SPM8为基础的VBM技术进行数据分析，比较患者组与对照组灰、白质体积存在差异的脑区。对体积增加的脑区及体积减小的脑区做相关分析，并将灰质体积存在差异的脑区与认知功能评分做相关分析。结果 脑梗死组患侧丘脑灰质体积减小，梗死病灶周围白质体积减小，而健侧辅助运动区（SMA）及枕中回灰质体积增加。增加的灰质体积与减少的脑实质体积呈负相关，健侧枕中回增加的灰质体积与认知功能呈正相关。结论 慢性期运动功能恢复良好的皮层下脑梗死患者同时存在结构损伤和结构重塑的现象，相关脑区结构的变化与认知功能存在相关性。Objective To investigate the cerebral structural plasticity with the voxel-based morphometry （VBM） technique, and the relationship between structural plasticity and cognitive scores in chronic stroke patients with Well-recovered global motor function. Methods Twenty-nine well-recovered patients after subcortical stroke and thirty healthy controls were recruited and the high resolutions magnetic resonance imaging （MRI） anatomy images of the whole brain were obtained. Structural alterations were further assessed via a VBM technique in SPM8. Group comparisons in gray matter volume （GMV）, white matter volume （WMV） were also evaluated. Moreover, we investigated both the correlation of the GMV with WMV and the correlation of the cognitive scores with the GMV that exhibit group differences. Results Compared with healthy controls, well-recovered patients with subcortical stroke exhibited significant extensive white matter atrophy in ipsilesional basal ganglia, thalamus and ipsilesional cerebral peduncle. Stroke patients also exhibited increased GMVs in contralesional supplementary motor area （SMA） and occipital medical gyrus. Moreover, the increased GMV of the contralesional occipital medical gyrus was significantly positive correlated with spatial attention ability, while the GMV and WMV changes were significantly negative correlated. Conclusion The brain structural impaired and reorganization were coexisted in well-recovered stroke patients. And the gray matter structural reorganization has significant correlation with cognitive ability.

关 键 词：脑梗死 基于体素的形态学分析 结构损伤 结构重塑 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]