视神经脊髓炎视放射损伤与视力损伤相关性的DTI研究  

Study of the Relationship between Optic Radiation and Visual Impairment in Patients with Relapsing Neuromyelitis Optica by DTI

作　　者：张小辉[1] 李咏梅[1] 曾春[1] 王静杰[1] 杜思霖[1] 

机构地区：[1]重庆医科大学附属第一医院放射科

出　　处：《中国医学计算机成像杂志》2017年第6期499-503,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金(81371523);重庆市卫计委医学科研重点课题(NO.2016ZDXM002);重庆市卫计委重点课题(NO.2012-1-017)~~

摘　　要：目的:探讨DTI技术在复发型视神经脊髓炎(RNMO)患者视力损伤早期诊断的价值及其病理损伤的可能机制。方法:视力损伤的RNMO患者及年龄与性别相匹配的健康志愿者各20例行DTI检查,并分别测量其视放射区的FA及MD值,采用扩展残疾状态量表(EDSS)对患者进行评分。应用SPSS19.0配对t检验及两样本t检验分别分析RNMO患者及健康对照组组内及组间两侧视放射的FA及MD值,以及与EDSS评分的相关性。结果:(1)健康对照组及RNMO患者组组内双侧视放射FA值(t=-0.40,P=0.70;t=0.63,P=0.54)及MD值(t=-0.72,P=0.48;t=0.17,P=0.87)均没有明显差异(P>0.05);RNMO患者左右两侧视放射FA值(t=-6.96,P=0.00;t=-8.19,P=0.00)均比正常对照组显著下降,MD值(t=5.41,P=0.00;t=5.91,P=0.00)均比正常对照组显著升高(P<0.05);(2)双侧视放射FA值(r=-0.37,P=0.05)和MD值(r=-0.37,P=0.05)与EDSS评分均没有明显的相关性(P≥0.05)。结论:DTI作为一种无创定量测量白质纤维束的MRI检查方法,有助于RNMO患者视力损伤的早期诊断,并为RNMO患者视力损害的病理改变提供影像学帮助。Purpose：To investigate the value of diffusion tensor imaging （DTI） in early diagnosis of visual impairment in relapsing neuromyelitis optica （RNMO） and its possible pathological mechanisms. Methods： Twenty cases RNMO patients with visual impairment and 20 cases age- and sex-matched healthy volunteers were undergone DTI. The fractional anisotropy （FA） value and mean diffusivity （MD） value of bilateral optic radiation in all the cases were measured. The expanded disability status scale （EDSS） of all RNMO patients was evaluated. The results were analyzed by the SPSS 19.0 software, paired t-test and 2-sample t-test were used to compare the FA values and MD values between different side of the optic radiation, and between RNMO patients and healthy controls, respectively. Results： The FA value of bilateral optic radiation （t=-0.40, P=0.70; t=0.63, P=0.54） and MD value （t=-0.72, P=0.48; t=0.17, P=0.87） in both groups were not with significant difference （P〉0.05）. The FA values of both sides of optic radiation in RNMO patients were significantly lower than that of the normal control group （t=-6.96, P=0.00; t--8.19, P=0.00）; the MD values were significantly higher than that of the normal control group （t=5.41, P=0.00; ~5.91, P=0.00）. There was no significant correlation between both FA （r=-0.37, P=0.05） and MD （r=-0.37, P=0.05） values of bilateral optic radiation and EDSS scores （P〉0.05）. Conclusion： As a quantitative MRI method in measurement of the white matter fiber, DTI is helpful to the early diagnosis of the visual impairment in patients with RNMO; DTI can provide help for understanding the pathological mechanism of the visual impairment at the same time.

关 键 词：磁共振成像 扩散张量成像 视神经脊髓炎 

分 类 号：R445.2[医药卫生—影像医学与核医学]