磁共振扩散峰度成像对脑小血管病早期脑损害的检测价值  

Value of magnetic resonance diffusion kurtosis imaging in the assessment of early brain damage in patients with cerebral small vessel disease

作　　者：司童 陈薇[1] 张尤桥[1] 郭岳霖 吴焕泽 容宇[1] 李洪标[1] 潘业鑫 郑晓红[1] 陈佳庆 SI Tong;CHEN Wei;ZHANG Youqiao;GUO Yuelin;WU Huanze;RONG Yu;LI Hongbiao;PAN Yexin;ZHENG Xiaohong;CHEN Jiaqing(The First Inpatient Ward,Department of Neurology,the Second Affiliated Hospital,Medical College,Shantou University,Shantou,Guangdong 515041;Department of Radiology,Shenzhen Bao′an Second People′s General Hospital(Group),Shenzhen,Guangdong 518100)

机构地区：[1]汕头大学医学院第二附属医院神经内科一病区,广东汕头515041 [2]深圳市宝安第二人民医院(集团)总医院影像科,广东深圳518100

出　　处：《郑州大学学报（医学版）》2019年第3期465-469,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨磁共振扩散峰度成像(DKI)技术在脑小血管病(CSVD)患者早期脑实质损害评价中的应用价值。方法:CSVD患者48例,其中血压正常12例(正常组),明确诊断为高血压少于10 a者24例(短病程组),明确诊断为高血压大于等于10 a者12例(长病程组)。测定患者的血压、NIHSS;行MRI检查,记录DKI参数,包括平均峰度值(MK)、平均弥散率值(MD)及各向异性分数值(FA)。结果:与血压正常组相比,长病程组和短病程组部分感兴趣区(ROI)中MK、FA下降,MD升高(P <0. 05)。与短病程组相比,长病程组部分ROI中MK下降(P <0. 05)。CSVD患者部分ROI中MK、MD和FA与血压相关(P <0. 05),部分ROI中MK、MD与NIHSS评分相关(P <0. 05)。结论:DKI在CSVD亚临床脑损害检测中有较高敏感度,MK更敏感;合并有高血压的CSVD患者脑实质损害更严重。Aim:To investigate the value of magnetic resonance diffusion kurtosis imaging(DKI)in the assessment of early brain damage in patients with cerebral small vessel disease(CSVD).Methods:A total of 48 patients with CSVD were recruited,including 12 cases with normal blood pressure(normal group),24 cases with hypertension less than 10 years(short-term group),and 12 cases with hypertension more than 10 years(long-term group).NIHSS was carried out,and fractional anisotropy value(FA),mean diffusivity value(MD)and mean kurtosis value(MK)were detected.Results:Compared with the normal group,MK and FA in some regions of interest(ROI)of the long-term group and short-term group decreased,and MD increased(P<0.05).Compared with the short-term group,MK in some ROIs of the long-term group decreased(P<0.05).For the CSVD patients,MK,MD and FA in some ROIs were related to blood pressure(P<0.05),MK and MD in some ROIs were related to NIHSS score(P<0.05).Conclusion:DKI has a higher sensitivity in the detection of subclinical stage of CSVD,and MK may be more sensitive than MD and FA.The brain parenchymal damage is more severe in CSVD patients with hypertension.

关 键 词：脑小血管病 磁共振扩散峰度成像 高血压 

分 类 号：R743.9[医药卫生—神经病学与精神病学]