常规MRI和DKI技术诊断肝豆状核变性疾病的对比研究  

The value of DKI in early diagnosis of hepatolenticular degeneration

作　　者：卢琦[1] 王安琴 张春芸[1] 武红利[2] 徐春生[1] LU Qi;WANG An-qin;ZHANG Chun-yun(he First Affiliated Hospital of Anhui University of Chinese Medicine,Image Center,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院影像中心,合肥230031 [2]安徽中医药大学,合肥230038

出　　处：《放射学实践》2018年第4期369-372,共4页Radiologic Practice

基　　金：国家重点基础研究973发展计划(2010CB530500);国家自然科学基金项目(81202768);安徽中医学院青年科学临床基金(2011qn022)

摘　　要：目的:对比分析常规MRI及DKI对肝豆状核变性疾病的诊断效能。方法:35例肝豆状核变性(HLD)患者及性别和年龄相匹配的30例健康志愿者(对照组),采用常规T2WI和DKI序列行3.0T MRI扫描,测量双侧豆状核和尾状核头部的平均扩散峰度(MK)、径向扩散峰度(RK)、轴向扩散峰度(AK)和T2信号变化率,采用校正t检验比较两组间各参数值的差异,采用ROC曲线分析各参数的诊断效能。结果:HLD组双侧豆状核的MK值及T2信号变化率(0.956±0.105、0.308±0.210)均高于对照组(0.832±0.086、0.641±0.473),差异具有统计学意义(P<0.05),两组间KA值及KR值的差异无统计学意义;HLD组双侧尾状核头部的MK、KA、KR值及T2信号变化率(0.691±0.123、0.825±0.124、0.597±0.175、0.602±0.440)均高于对照组(0.567±0.066、0.696±0.080、0.497±0.079、0.326±0.225),差异具有统计学意义(P<0.05)。ROC曲线分析结果显示,双侧豆状核的MK值和T2信号变化率的曲线下面积(AUC)分别为0.825和0.708(P<0.05),双侧尾状核头部的MK、KR和KA值及T2信号变化率的曲线下面积分别为0.814、0.822、0.670和0.686(P<0.05)。结论:DKI技术对显示大脑微观结构的变化较常规MRI序列的敏感性和特异性更高,更有利于肝豆状核变性疾病的诊断。Objective:To evaluate the sensitivity and specificity of diffusion kurtosis imaging(DKI)for detecting hepatolenticular degeneration disease(HLD)and compared with conventional magnetic resonance imaging(MRI).Methods:A total of 35 HLD patients in our hospital were enrolled and 30 age-and sex-matched healthy volunteers were recruited as control group.The MRI examination was performed with conventional MR T 2-weighted sequence and DKI sequence using a 3.0-Tesla MR system.Thereafter,the data were analyzed with methods of manual ROI using program of ADW4.6,and DKI parameters including mean kurtosis(MK),radial kurtosis(RK)and axial kurtosis(AK),and T 2-signal intensity ratio were obtained.Results:Compared to healthy volunteers,MK and T 2-ratio of the lenticular nucleus(LN)in HLD group(0.956±0.105 and 0.308±0.210)were higher than those in control group(0.832±0.086 and 0.641±0.473),the difference was significant with P-values less than 0.05.MK,AK,RK and T 2-ratio of the bilateral head of caudate nucleus(HCN)in HLD group(0.691±0.123,0.825±0.124,0.597±0.175,0.602±0.440)were all higher than those in control group(0.567±0.066,0.696±0.080,0.497±0.079,0.326±0.225),the differences were significant with P-values less than 0.05.The area under ROC curve(AUC)of MK,T 2-ratio in LN was 0.825 and 0.708,respectively.The AUC of MK,AK,RK and T 2-ratio in HCN was 0.814,0.822,0.670 and 0.686 respectively.The differences were significant with P-values less than 0.05 for all DKI indexes.Conclusion:The technique of DKI provides higher sensitivity and specificity than conventional MRI to detect the changes of brian microstructure,it may provide effective value for diagosis.

关 键 词：扩散峰度成像 磁共振成像 脑部疾病 肝豆状核变性 基底核 

分 类 号：R445.2[医药卫生—影像医学与核医学] R747.9[医药卫生—诊断学]