膝前交叉韧带自体肌腱保残重建术后静息态脑功能磁共振成像的初步研究  

A preliminary study on resting-state functional magnetic resonance imaging of brain after anterior cruciate ligament preservation reconstruction with autologous tendon

作　　者：王家骐[1] 刘浩[2] 王湘彬[2] 张英琪[1] 王树青[1] 史鹰勤[2] 张敏[2] 赵小虎 Wang Jiaqi;Liu Hao;Wang Xiangbin;Zhang Yingqi;Wang Shuqing;Shi Yingqin;Zhang Min;Zhao Xiaohu(Department of Orthopedics,Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China;Department of Radiology,Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China;Department of Radiology,the Fifth People′s Hospital of Shanghai,Fudan University,Shanghai 200240,China)

机构地区：[1]同济大学附属同济医院骨科,上海200065 [2]同济大学附属同济医院医学影像科,上海200065 [3]复旦大学附属上海市第五人民医院放射科,上海200240

出　　处：《中华医学杂志》2019年第19期1479-1483,共5页National Medical Journal of China

基　　金：上海市卫生和计划生育委员会课题面上项目(201540215,201840018);上海市科委项目(18411970300).

摘　　要：目的利用静息态脑功能磁共振成像探讨前交叉韧带自体肌腱保留残端重建术后大脑皮质功能异常的可能机制。方法以2015年6月至2019年2月同济大学附属同济医院18例[男10例,女8例,年龄(36±10)岁]左膝前交叉韧带断裂、关节镜下自体肌腱保残重建术患者为研究对象,同时入选具有可比性的健康对照17位。于重建术后2~12周进行静息态核磁共振脑功能扫描。采用SPM8软件包和RESTplus软件进行预处理,计算两组大脑低频振幅(ALFF)和比率低频振幅(fALFF)值,分别对两组受试者ALFF及fALFF进行双样本t检验,并采用AlphaSim进行多重检验校正,对照研究患者脑功能异常活动特征。结果与对照比较,膝关节前交叉韧带自体肌腱重建术后患者大脑ALFF在双侧中央扣带回、累及辅助运动区显著高于正常对照组(校正前P<0.01,AlphaSim校正后P<0.05)。fALFF激活簇1在大脑右侧中央后回、累及右侧顶下小叶、右侧缘上回显著高于正常对照组(校正前P<0.01,AlphaSim校正后P<0.05);激活簇2在右侧中央扣带回、累及右侧辅助运动区显著高于正常对照组(校正前P<0.01,AlphaSim校正后P<0.05)。结论前交叉韧带自体肌腱保残重建术后,患者大脑运动感觉和调控有关的皮质活动发生异常改变。Abstract Objective To preliminarily study on the possible mechanism of cerebral cortical dysfunction pattern after anterior cruciate ligament (ACL) preservation reconstruction with autologous tendon through resting-state functional magnetic resonance imaging (fMRI). Methods From June 2015 to February 2019, 18 patients (10 males and 8 females with an average age of (36±10) years) with left anterior cruciate ligament rupture and treated with arthroscopic preservation reconstruction with autologous tendon were enrolled in this study, and 17 comparable healthy controls were included in Tongji Hospital of Tongji University. fMRI was performed after the postoperative period (2 to 12 weeks). The fMRI data were preprocessed by SPM8 software package and RESTplus software. The amplitude of low-frequency fluctuation (ALFF) and the fractional amplitude of low-frequency fluctuation (fALFF) in those two groups were calculated. Two-sample t-test was performed on ALFF and fALFF of the two groups, and multiple test corrections were performed by using AlphaSim. These methods were used for contrast studies on the characteristic activities of the brain dysfunction. Results Compared with those in the control, ALFF in the central cingulate gyrus (cingulum_mid_bilateral), involving the auxiliary movement zone (supp_motor_ area) were significantly higher in the patients (P<0.01 before correction, P<0.05 after AlphaSim correction). The fALFF in activation cluster 1 was significantly higher in the right central gyrus (postcentral_R), the right lower lobule (parietal_inf_R), and the right upper margin (supramarginal_R) in the patients than that in the normal control group, respectively (P<0.01 before correction, P<0.05 after AlphaSim correction);the fALFF in activation cluster 2 in the right central cingulate gyrus (cingulum_mid_R), involving the right auxiliary movement zone (supp_motor_area_R) was significantly higher in the patients than that in the normal control group, respectively (P<0.01 before correction, P<0.05 after AlphaSim cor

关 键 词：前交叉韧带 自体肌腱 功能磁共振成像 低频振幅 比率低频振幅 

分 类 号：R445.2[医药卫生—影像医学与核医学]