慢性期Leber遗传性视神经病变视放射MR扩散张量成像研究  

MR diffusion tensor imaging of optic radiation in chronic Leber＇s hereditary optic neuropathy

作　　者：王玲[1] 张艳秋[1] 范珂[2] 田勤[1] 徐晓娜[1] 史大鹏[1] 

机构地区：[1]郑州大学人民医院河南省人民医院放射科河南省神经疾病影像诊断与研究重点实验室,450003 [2]河南省眼科研究所

出　　处：《中华放射学杂志》2017年第6期407-411,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金（81271534）

摘　　要：目的采用MR扩散张量成像（DTI）观察慢性期Leber遗传性视神经病变（LHON）视放射改变。方法2011年3月至2014年12月收集25例LHON患者（LHON组）和28名年龄、性别相匹配的正常对照者（对照组），分别进行全脑DTI扫描和视网膜光学相干断层成像（OCT）检查。测量受试者双侧视放射各向异性分数（FA）、平均扩散值（MD）、平行扩散率（λ//）、垂直扩散率（λ⊥），以及OCT测量参数平均视网膜神经纤维层（RNFL）厚度和颞象限RNFL厚度。LHON组与正常对照组之间各参数（符合正态分布）的比较采用两独立样本t检验，LHON组内左、右眼之间测量结果的比较采用配对t检验。结果LHON组DEC图上显示双侧视放射神经纤维明显稀疏、纤细，右侧视放射FA、MD、λ//、λ⊥值分别为0.523±0.050、（0.903±0.061）×10^-9mm^2/s、（4.999±0.097）×10^-9mm^2/s、（4.126±0.065）×10^-9mm^2/s，左侧视放射对应值分别为0.537±0.041、（1.057±0.573）×10^-9mm^2/s、（5.052±0.119）×10^-9mm^2/s、（4.138±0.072）×10^-9mm^2/s。与对照相比较，双侧FA值显著下降，双侧λ⊥值、右眼MD显著升高，差异均具有统计学意义（t值分别为－6.524、－6.045、6.932、6.454、3.471，P值均〈0.05），双侧λ//和左眼MD值与对照组相比差异无统计学意义（t值分别为－0.457、1.221、1.833，P值均〉0.05）；LHON组内左右侧视放射参数比较差异均无统计学意义（P〉0.05）。LHON组右眼平均RNFL厚度和颞象限RNFL厚度分别是（59.36±10.94）和（41.72±9.43）μm，左眼分别为（60.12±9.81）和（44.72±9.43）μm。与对照组比较，LHON组双侧平均RNFL厚度和颞象限RNFL厚度均显著变薄，差异有统计学意义（t值分别为－16.357、－10.398、－17.169、－9.672，P值均〈0.05）；患者组内左右眼之间平均RNFL厚度的差异无统计学意义（t=0.959, P〉0.05），左右眼之间颞象限RNFL厚度的差异有统ObjectiveTo observe quantitatively the optic radiation alterations in chronic Leber＇s hereditary optic neuropathy （LHON） using MR diffusion tensor imaging at 3.0 T.MethodsTwenty-five patients with chronic LHON and twenty-eight sex- and age-matched disease-free control subjects were enrolled from March 2011 to December 2014. The whole brain DTI examination and retinal optical coherence tomography were performed in all the subjects. The parameters values of optic radiation including fractional anisotropy（FA）,mean diffusivity（MD）,principal eigenvalue（λ//）,orthogonal eigenvalue（λ⊥） and average retinal nerve fiber layer （RNFL） thickness and temporal retinal nerve fiber layer（RNFL） thickness were measured. For DTI and OCT parameters, differences between patients and controls and differences right and left of the patient group were evaluated using independent-samples t test and paired t test respectively.ResultsIn LHON patients, the DEC maps showed that the bilateral optic radiation fibers were obviously sparse and slender. The values of FA, MD, λ// and λ⊥ in the right optic radiation were 0.523±0.050, （0.903±0.061） ×10^-9 mm^2/s, （4.999±0.097） ×10^-9 mm^2/s and （4.126±0.065） ×10^-9 mm^2/s respectively, and the corresponding values of left optic radiation were 0.537±0.041, （1.057±0.573）×10^-9 mm^2/s,（5.052±0.119）×10^-9 mm^2/s and （4.138±0.072）×10^-9 mm^2/s. Compared with optic radiation in the control group, the bilateral FA was significant reduced, the bilateral λ⊥ value and right MD value were significant increased （t=-6.524, -6.045, 6.932, 6.454, 3.471, P〈0.05） . However, there were no significant difference of the bilateral λ// and left MD （t=-0.457, 1.221, 1.833, P〉0.05） .There were no significant differences in FA, MD, λ// and λ⊥ between the left and right eyes in LHON patients（P〉0.05）. The values of average RNFL thickness and temporal RNFL thickness in right eyes were （59.36±10.94） and （41.72±9.43） μm

关 键 词：视神经疾病 磁共振成像 对比研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R774.6[医药卫生—诊断学]