扩散峰度成像对不同分级高血压患者脑微结构损伤的研究  

Study of diffusion kurtosis imaging on brain microstructural damage in patients with different grades of hypertension

作　　者：樊秋菊 谭辉[1,2] 于楠 贺太平[1,2] 杨创勃 于勇[1,2] 董玉玉 李悦[2] FAN Qiuj u;TAN Hui;YU Nan;HE Taiping;YANG Chuangbo;YU Yong;DONG Yuyu;LI Yue(Department of Radiology,the Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang,Shaanxi Province 712000,China;Medical Technolog y College,Shaanxi University of Chinese Medicine,Xianyang,Shaanxi Province 712000,China)

机构地区：[1]陕西中医药大学附属医院影像科,陕西咸阳712000 [2]陕西中医药大学医技学院,陕西咸阳712000

出　　处：《实用放射学杂志》2020年第6期859-862,共4页Journal of Practical Radiology

基　　金：陕西中医药大学青年项目(2017QN10);陕西中医药大学学科创新团队项目(2019-QN09)。

摘　　要：目的探讨DKI技术平均峰度(MK)值对原发性高血压脑组织损伤微观结构变化的评估价值。方法对55例高血压患者进行DKI扫描,并分为Ⅰ级、Ⅱ级、Ⅲ级。选取20例血压正常、年龄匹配的健康志愿者(正常组)。获取受试者脑白质(额叶白质、顶叶白质、侧脑室旁白质、半卵圆中心、胼胝体膝部、胼胝体压部)、灰质核团(尾状核头、壳核及丘脑)的MK值,采用两独立样本t检验及单因素方差分析比较正常组与高血压组组间与组内的差异。结果高血压组尾状核头、壳核、丘脑、胼胝体压部、额叶白质、顶叶白质、侧脑室旁白质及半卵圆中心的MK值均随血压升高而降低,而胼胝体膝部的MK值,Ⅰ级较Ⅱ级低,但差异未见明确统计学意义;Ⅰ级仅在额、顶叶白质差异有统计学意义;Ⅱ级在额叶白质、顶叶白质、半卵圆中心、侧脑室旁白质、胼胝体压部、壳核及丘脑差异有统计学意义;Ⅲ级各部位与正常组对比MK值均降低,差异有统计学意义。Ⅱ级与Ⅰ级相比,未见明确差异;Ⅱ级与Ⅲ级对比,顶叶白质差异有统计学意义;Ⅰ级与Ⅲ级对比,顶叶白质,半卵圆中心、胼胝体压部、尾状核头及丘脑差异有统计学意义。结论DKI技术可以检测出随着血压升高,脑实质发生进行性脑损害,并可以敏感地发现白质及灰质早期微观结构的改变。Objective To explore the value of mean kurtosis(MK)(parameter of DKI)technique in the evaluation of microstructural changes of brain tissue in primary hypertension.Methods DKI scans were performed on 55 patients with hypertension which were divided intoⅠ,Ⅱ,Ⅲgrades.20 cases of normal blood pressure,age matched healthy volunteers were set as normal group.The MK values in the white matter(the front lobe,parietal lobe,body of lateral cerebral ventricle,centrum semiovale,genu of corpus callosum,corporis callosi splenium)and the gray matter(the caudate nucleus,putamen,thalamus)were extracted.Indepandent sample t test and one-way AVOVA were performed to evaluate the significance of the intra and inter group difference about MK value.Results In the hypertension group,the MK values of the caudate nucleus,putamen,thalamus,corporis callosi splenium,front lobe,parietal lobe,body of lateral cerebral ventricle and centrum semiovale decreased with increasing blood pressure,while the value of the genu of corpus callosum inⅠgrade was lower than that in gradeⅡ,but the difference was not statistically significant.For gradeⅠthere was only statistically significant in the front lobe and parietal lobe;For gradeⅡthere was statistically significant in the front lobe,parietal lobe,centrum semiovale,body of lateral cerebral ventricle,corporis callosi splenium,putamen and thalamus.The MK values inⅢgrades were lower than those in the normal group,and the difference was statistically significant.There was no difference between gradeⅡand gradeⅠ;the difference of white matter in parietal lobe was statistically significant between gradeⅡand gradeⅢ.GradeⅠand gradeⅢwere compareded,statistically significant were found in the parietal lobe,centrum semiovale,corporis callosi splenium,caudate nucleus and thalamus.Conclusion DKI technology can detect the occurrence of progressive brain damage in the brain parenchyma with the increase of blood pressure,and can sensitively detect the changes of early microstructure of white m

关 键 词：原发性高血压 扩散峰度成像 灰质 白质 

分 类 号：R544.11[医药卫生—心血管疾病] R445.2[医药卫生—内科学]