急性一氧化碳中毒脑损伤的磁共振扩散张量成像  

Diffusion tensor imaging for brain damage of acute CO intoxication

作　　者：朱亚男[1] 燕浩[2] 姚俊[1] 叶鹏[1] 梁煜坤[1] 向阳[1] 蔡定萍[1] 李正军[1] 周和平[1] ZHU Yanan YAN Hao YAO Jun YE Peng LIANG Yukun XIANG Yang CAI Dingping LI Zhengjun ZHOU Heping(Medical Imaging Centre, Ankang Central Hospital, Ankang 725000,Chin)

机构地区：[1]安康市中心医院影像中心,陕西安康725000 [2]西安电子科技大学语言学系

出　　处：《实用放射学杂志》2016年第10期1489-1493,1501,共6页Journal of Practical Radiology

基　　金：国家自然科学基金项目（31400962）;陕西省卫生和计划生育委员会科研项目（2014E9）.

摘　　要：目的：利用磁共振扩散张量成像（DTI ）评估急性一氧化碳（CO）中毒患者的脑结构损伤情况。方法25例急性（5.0 d±1.44 d） CO 中毒患者和37例性别、年龄、利手、受教育程度匹配的健康志愿者进行 DTI 扫描，获得扩散张量纤维束成像（DTT）图像，并分别测量双侧小脑半球（齿状核）、黑质、海马、额叶白质（侧脑室前角前下方、侧脑室体部上方）、尾状核头、苍白球、丘脑、内囊前肢、内囊后肢、枕叶白质（视中枢）、顶叶白质（侧脑室体部上方）及胼胝体膝部、压部共26个感兴趣（ROI）的各向异性分数（FA）值和表观扩散系数（ADC）值，进行组间配对 t 检验。结果病患组双侧苍白球、双侧内囊前肢、双侧黑质、右侧小脑、左侧额叶下部白质、右额叶上下部白质、胼胝体膝部的 FA 值显著低于对照组（P 〈0.05）。病患组右侧黑质、左侧苍白球的 ADC 值显著降低（P 〈0.05），病患组右额叶上下部白质及双侧枕叶白质 ADC 值显著升高（P 〈0.05）。结论急性 CO 中毒患者广泛脑微结构受损，提示脑微结构的原发损伤可能是 CO 中毒迟发性脑病潜在的病理生理基础。Objective To investigate altered microstructural integrity in acute carbon monoxide（CO）intoxication by diffusion tensor imaging （DTI）.Methods A total of 25 CO intoxication patients （5.0±1.44 post-intoxication）and 37 healthy volunteers matched with age, sex and educational level were involved and underwent DTI.The fractional anisotropy （FA）and apparent diffusion confficient （ADC） of total 26 regions of bilateral cerebellum,substantia nigra,hippocampus,white matter of frontal lobe,head of caudate nucleus,pallidum,thalamus, anterior limb of internal capsule,posterior limb of internal capsule,white matter of occipital lobe,white matter of parietal lobe,and genu of corpus callosum,splenium of corpus callosum were measured.Compared the patients against control for FA and ADC by paired t-test.Results FA of patients with CO intoxication decreased in bilateral pallidum,anterior limb of internal capsule,substantia nigra,right cerebellum,left below frontal white matter,right frontal white matter and genu of corpus callosum （P 〈0.05）.ADC decreased in right substantia nigra,and left pallidum （P 〈0.05）.ADC increased in right frontal white matter and bilateral occipital lobe white matter （P〈0.05）.Conclusion There is loss of microstructural integrity in acute CO intoxication,perhaps representing the underlying mechanism of delayed encephalopathy after carbon monoxide poisoning.

关 键 词：一氧化碳 中毒 脑病 扩散张量成像 磁共振成像 

分 类 号：R595.1[医药卫生—内科学] R651.15[医药卫生—临床医学]