基于扩散张量成像的轻型颅脑创伤损伤机制研究  

The mechanism of mild traumatic brain injury based on diffusion tensor imaging

作　　者：陶芳旭 樊丽丹 张凌[2] 张泽明[2] 王智清[2] 陈耀康[2] 刘军[1] TAO Fang-xu;FAN Li-dan;ZHANG Ling;ZHANG Ze-ming;WANG Zhi-qing;CHEN Yao-kang;LIU Jun(Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011 Hu＇nan, China;Medical Imaging Center, Panzhihua Central Hospital, Panzhihua 617067, Sichuan, China)

机构地区：[1]中南大学湘雅二医院放射科,长沙410011 [2]四川省攀枝花市中心医院医学影像中心,617067

出　　处：《中国现代神经疾病杂志》2018年第4期252-258,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金资助项目(项目编号：81671671)

摘　　要：目的分析轻型颅脑创伤患者扩散张量成像(DTI)参数及其与神经心理学测验的相关性,探讨轻型颅脑创伤急性期损伤机制。方法共16例轻型颅脑创伤患者和15例性别、年龄、受教育程度相匹配的正常对照者,均行头部MRI检查,包括T_1WI、T_2WI、T_2-FLAIR成像和DTI,采用基于体素的形态学分析计算部分各向异性(FA)值、平均扩散率(MD)值和表观扩散系数(ADC)值,同时行神经心理学测验,包括Beck抑郁量表(BDI)、状态-特质焦虑量表[分为状态焦虑量表(SAI)和特质焦虑量表(TAI)],Spearman秩相关分析探讨各脑区FA值、MD值和ADC值与神经心理学测验的相关性。结果与正常对照者相比,轻型颅脑创伤患者右侧额叶补充运动区FA值降低,右侧额叶中央前回、缘上回和顶叶FA值升高;双侧额叶、顶叶和右侧扣带回MD值升高;双侧额叶和右侧顶叶、岛叶ADC值升高。轻型颅脑创伤患者SAI评分高于正常对照者[20.50(13.25,29.75)分对11(8,12)分;Z=-3.493,P=0.000],而BDI评分和TAI评分组间差异无统计学意义(均P>0.05)。Spearman秩相关分析显示,上述异常脑区FA值(rs=0.369,P=0.478)、MD值(rs=0.295,P=0.421)和ADC值(rs=0.401,P=0.394)与SAI评分均无关联性。结论轻型颅脑创伤急性期患者存在多个脑区DTI参数和相关神经心理变化,DTI可以为轻型颅脑创伤研究提供影像学标记。Objective To analyze the correlation between diffusion tensor imaging（DTI） andneuropsychological tests in paMtientso dwsi th mild traumatic brain injury（m TBI）, and to explore the damagemechanism of acute m TBI. ethA total of 16 m TBI patients and 15 sex-, age-and education-matched healthy controls were scanned at 3.0T MRI, including T1WI, T2WI, T2-FLAIR and DTI. Voxel-based morphometry（VBM） was used to calculate fractional anisotropy（FA）, mean diffusivity（MD） andapparent diffusion coefficient（ADC）. Neuropsychological tests including Beck Depression Inventory（BDI）,State Anxiety Inventory（SAI） and Trait Anxiety Inventory（TAI） were performed. Spearman rank correlationanalysis explored the correlation between FA, MD, ADC values and neuropsychological tests. Results Compared with control group, FA value was decreased in supplementary motor area（SMA） of right frontallobe, and increased in precentral gyrus and supramarginal gyrus of right frontal lobe and right parietal lobe;MD value was increased in bilateral frontal lobes, parietal lobes and right cingulate gyrus; ADC value wasincreased in bilateral frontal lobes, right parietal lobe and insular lobe in m TBI group. SAI score in m TBIgroup was significantly higher than that in control group [20.50（13.25, 29.75） score vs. 11（8, 12） score; Z =-3.493, P = 0.000）, while BDI and TAI scores had no significant difference between 2 groups（P 〉0.05, for all）. Spearman rank correlation analysis showed there was no correlation between FA（rs= 0.369, P = 0.478）,MD（rs=C 0.295, P = 0.421） and ADC（rs= 0.401, P = 0.394） values of abnormal brain regions and SAIscore. onclusions DTI parameters and related neuropsychological changes of multiple brain regionsexist in acute mTBI. This study suggest that DTI can serve as a potential biomarker of mTBI.

关 键 词：颅脑损伤 磁共振成像 弥散 神经心理学测验 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.15[医药卫生—诊断学]