正常眼压性青光眼磁共振扩散张量成像技术(DTI)研究及其与临床分期的相关性  

Study and correlative analysis between DTI parameters and clinical stages in normal tension glaucoma

作　　者：李汉林[1] 邵毅[1] 彭志优[1] 周琼[1] 裴重刚[1] 姜建[2] 王博[2] 

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006 [2]南昌大学第一附属医院影像科,江西省南昌市330006

出　　处：《眼科新进展》2016年第12期1129-1132,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81160118;81400372);全国临床医药研究专项基金(编号:L2012052);江西省远航工程(编号:2014022);江西省学位与研究生教育教学改革研究项目(编号:2015);江西省科技平台建设项目(编号:2013116);江西省青年科学基金(编号:20151BAB215016);江西省科技支撑计划项目(编号:20161BBG70164);江西省教育厅科技计划项目(编号:GJJ150242);江西省卫计委科技计划项目(编号:20155131);赣江学者计划(2015)~~

摘　　要：目的使用磁共振扩散张量成像技术(diffusion tensor imaging,DTI)研究正常眼压性青光眼(normal tension glaucoma,NTG)患者视路的改变,探讨其与NTG临床分期的相关性。方法对30例(60眼)NTG患者(NTG组)和30例(60眼)健康志愿者(对照组)进行了前瞻性研究。NTG临床分期使用Hodapp-Anderson-parrish(HAP)系统进行分类。所有受试者均进行磁共振DTI扫描检测,利用软件处理定量获取视神经、视交叉、视束的各向异性分数(fractional anisotropy,FA)、平均扩散系数(average diffusion coefficient,ADC),对比分析NTG组与对照组视路改变区域,并检验NTG组视路改变程度与临床分期的相关性。结果与对照组相比,NTG组视神经、视交叉及视束的FA值均明显降低,ADC值均明显升高(均为P<0.001);NTG组两侧视神经、视交叉、视束的平均FA值和ADC值均与NTG临床分期具有相关性,其中视神经的FA值与NTG临床分期相关性最强(r=0.752,P<0.001),而视束的ADC值与NTG临床分期相关性最弱(r=-0.331,P<0.001)。结论 DTI有望成为临床诊断NTG的可能补充手段。Objective To study the changes of optic pathway in normal tension glaucoma （NTG） by using diffusion tensor imaging （ DTI）, and discuss the correlation between the DTI-derived parameters and NTG clinical stages. Meth- ods Thirty cases of NTG patients and 30 cases of healthy control volunteers were prospectively studied. NTG clinical stages were classified by using Hodapp- Anderson-parrish （HAP） system. All subjects underwent 3.0T MRI-DTI scan test to obtain the fractional anisotropy （FA） value and average diffusion coefficient （ADC） value of the optic nerve, optic chiasm and optic tract by using quantitative software process. The visual pathway change region between NTG group and con- trol group was compared, and the correlation between the changes of visual path- way and degree of clinical staging in the NTG group was tested. Results Com- pared with the control group, FA values of optic nerve, optic chiasm and optic tract in the NTG group showed the significant decrease, while the ADC values were significantly increased （ all P 〈 0. 001 ） ; FA and ADC values of the bilateral optic nerve, optic chiasm and optic tract in the NTG group were correlated with NTG clinical stages. FA value of optic nerve in the NTG group had the strongest correlation with NTG clinical stages （ r = 0. 752 ,P 〈 0.001 ）, while ADC value of optic tract in the NTG group had the weakest correlation with NTG clinical stages （ r = - 0.331 ,P 〈 0.001 ）. Conclusion DTI can be used as a potential noninva- sive manner for clinically diagnosing NTG.

关 键 词：正常眼压性青光眼 磁共振扩散张量成像技术 临床分期 

分 类 号：R775.5[医药卫生—眼科]