静息态功能磁共振在创伤性颅脑损伤昏迷患者损伤评估及预后预测中的研究  

Resting-state functional magnetic resonance imaging in injury assessment and prognosis prediction of comatose patients with traumatic brain injury

作　　者：张明哲[1] 郭洪[1] 孙昭胜[1] 杨雪辉[1] 刘兵[1] 康志雷[1] Zhang Mingzhe;Guo Hong;Sun Zhaosheng;Yang Xuehui;Liu Bing;Kang Zhilei(Harrison International Peace Hospital, Hengshui, Hebei 053000, China)

机构地区：[1]哈励逊国际和平医院,河北衡水053000

出　　处：《中华生物医学工程杂志》2019年第3期340-345,共6页Chinese Journal of Biomedical Engineering

基　　金：河北省卫生厅重点科技研究计划(ZD20140403).

摘　　要：目的应用静息态功能磁共振(rs-fMRI)成像的低频振幅(ALFF)、功能连接(FC)的方法及磁共振扩散张量成像(DTI)对重型颅脑损伤(sTBI)昏迷患者进行损伤评估及预测其预后。方法用rs-fMRI和DTI对21例sTBI患者(病例组)和21例受教育程度、年龄、性别均相匹配的健康被试(对照组)进行成像检查,比较两组间脑区ALFF、FC及各向异性(FA)的差异。根据sTBI患者的预后情况将病例组分为清醒组及昏迷组,比较两组间ALFF、FC的差异。结果与正常对照组比较,病例组患者默认网络内多个区域ALFF、FC明显降低(P<0.05),半卵圆中心、胼胝体膝部和压部、内囊前肢和后肢的FA值也明显降低(P<0.05)。与昏迷组比较,清醒组患者默认网络内多个区域的ALFF、FC明显增高(P<0.05)。结论预后更好的sTBI患者大脑默认网络的脑区ALFF、FC增高。Objective To evaluate the severe traumatic brain injury (sTBI) in coma patients by amplitude of low-frequency fluctuation (ALFF) of resting-state functional magnetic resonance imaging (rs-fMRI), functional connectivity (FC) methods and magnetic resonance diffusion tensor imaging (DTI), and to predict its prognosis. Methods Twenty-one sTBI patients (study group) and 21 healthy subjects (control group) with matched education degree, age and gender were examined by rs-fMRI and DTI. The differences in ALFF, FC and anisotropy (FA) between the two groups were compared. According to the prognosis of sTBI patients, the patients in the study group were divided into awake group and coma group, and the differences in ALFF and FC between the two groups were compared. Results Compared with the normal control group, the ALFF and FC values in multiple regions of default network in the study group significantly decreased. The FA values in semioval center, genu and splenium of corpus callosum, and anterior and posterior limbs of internal capsule significantly decreased (P<0.05). Compared with the coma group, the ALFF and FC values in multiple regions of default network in the awake group significantly increased (P<0.05). Conclusion The ALFF and FC values increase in brain regions of default network in sTBI patients with better prognosis.

关 键 词：功能磁共振 颅脑损伤 昏迷 预后预测 

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]