VBM-DARTEL法观察带状疱疹后遗神经痛患者脑灰质体积的形态学改变  

Observation of morphological changes of brain gray matter volume in patients with postherpetic neuralgia using VBM-DARTEL method

作　　者：王思丹 鲁毅[1] 赵卫[1] 孙学进[1] 解玥 赵建山 刘爽[1] 

机构地区：[1]昆明医科大学第一附属医院影像科,云南昆明650032

出　　处：《实用放射学杂志》2017年第9期1337-1340,1356,共5页Journal of Practical Radiology

摘　　要：目的 观察带状疱疹后遗神经痛（PHN）患者全脑灰质形态学改变，探讨其形态学改变与PHN患者视觉模拟评分（VAS）及病程之间的相关性。方法 对17例PHN患者及17例正常对照的3D T1WI结构图像进行预处理，采用VBM-DARTEL法比较2组分割后的脑灰质体积，并分析脑灰质体积改变与PHN患者VAS及病程之间的相关性。结果 相对于正常对照组，PHN患者脑灰质体积减小的脑区包括：双侧眶额区（眶回及直回）、左侧额下回、左侧岛叶、左侧尾状核、右侧扣带回、左侧颞上回、左侧楔叶、双侧小脑前后叶；PHN患者脑灰质体积增加的脑区包括：双侧额上回、左侧额中回、小脑蚓部、脑桥；PHN组两侧半球脑灰质体积改变不对称（左侧＞右侧）；PHN患者脑灰质体积异常脑区与VAS及病程之间均无相关性。结论 VBM-DARTEL法揭示PHN患者存在广泛脑灰质体积异常，这些改变可能在疼痛的形成及慢性状态维持中发挥重要作用。Objective To investigate the morphological changes of whole brain gray matter in patients with postherpetic neuralgia （PHN）, and evaluate the correlation between morphological changes of whole brain gray matter,visual analogue scale （VAS） and duration of PHN.Methods By using VBM-DARTEL method,firstly the 3D T1WI structure images of 17 patients with PHN and 17 normal control were preprocessed,then the segmented gray matter volume was compared between the two groups, and the correlation between difference of cerebral gray matter volume, VAS and duration of PHN were analyzed.Results Compared with the normal control, gray matter decrease in PHN group was found in bilateral orbital frontal regions（orbital gyrus,rectus gyri）,left inferior frontal gyrus, left insular lobe, left caudate, right cingulate gyrus,left superior temporal gyrus, left cuneus, bilateral cerebellum posterior lobe and bilateral cerebellum anterior lobe.And gray matter increase in PHN group was found in bilateral superior frontal gyri, left middle frontal gyrus, vermis, pons. The gyrus volume change for two hemispheres was asymmetric （the left side greater than the right side}.These different brain region changes in gray matter volume for patients with PHN were not correlated with VAS and duration of PHN.Conclusion VBM-DARTEL can evaluate widespread gray matter changes in patients with PHN, which is extremely important for the development and maintenance of pain in postherpetic neuralgia.

关 键 词：带状疱疹后遗神经痛 VBM-DARTEL 灰质体积 磁共振成像 

分 类 号：R752.12[医药卫生—皮肤病学与性病学] R742[医药卫生—临床医学]