终末期肾病患者大脑半球间镜像同伦功能连接研究  

Interhemispheric Functional Connectivity in Patients with End-stage Renal Disease:A Resting-state Functional Magnetic Resonance Imaging Study

作　　者：贾凤玉[1] 薛岩 王素霞[1] 刘文渊[1] 景颖[1] 赵寒辉 李勃[2] 刘锴[2] 张洪彬[1] 赵铁柱 秦瑜 卢文婷 苏曰龙 孙钢[2] JIA Fengyu;XUE Yan;WANG Suxia(Department of Blood Purification,The 960th Hospital of PLA Joint Logistics Support Force,Jinan,Shandong Province 250031,P.R.China)

机构地区：[1]中国人民解放军联勤保障部队第960医院血液净化科,济南250031 [2]中国人民解放军联勤保障部队第960医院医学影像科,济南250031 [3]山东中医药大学附属医院放射科,济南250011

出　　处：《临床放射学杂志》2021年第1期11-15,共5页Journal of Clinical Radiology

基　　金：中国人民解放军联勤保障部队第960医院2017年度院长基金资助项目(编号:2017MS12)。

摘　　要：目的应用静息态功能磁共振成像(rs-fMRI)基于体素镜像同伦连接(VMHC)方法研究终末期肾病(ESRD)患者两侧大脑半球间同伦功能连接改变。方法利用GE 3.0T MR采集50例ESRD患者和40名健康者(对照组)的rs-fMRI数据。采用简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)对所有受试者进行评分。利用REST软件计算ESRD组和对照组两侧大脑半球间的VMHC值,获得VMHC值有显著统计学意义的脑区,分析ESRD患者差异脑区的VMHC值与MMSE、MoCA评分、临床参数间的相关性。结果与对照组比较,ESRD组双侧枕中回/枕下回、距状回/舌回/楔叶、中央前回/中央后回/颞上回和顶下小叶的VMHC值显著降低,未发现VMHC值显著升高的脑区。使用受试者工作特征(ROC)曲线分析显示四个差异脑区曲线下面积(AUC)分别是0.880、0.878、0.921和0.884。结论在静息态下,ESRD患者两侧大脑半球间的功能连接异常下降。初步证明两侧半球间的VMHC能作为一种有效的辅助方法评估ESRD患者神经失连接。Objective To explore the alterations in interhemispheric functional connectivity in patients with end-stage renal disease(ESRD)using resting-state functional magnetic resonance(MR)imaging with voxel-mirrored homotopic connectivity(VMHC)algorithm.Methods 50 patients with ESRD and 40 healthy control subjects underwent resting-state functional MR imaging in a GE3.0 scanner.All subjects underwent Mini-Mental State Examination(MMSE)test and Montreal cognitive assessment(MoCA)test.VMHC values were calculated between the two groups using REST software and the statistical map with significant differences of VMHC value was obtained.Correlations were performed between VMHC values and MMSE,MoCA and clinical parameters.Results Compared with healthy controls,patients with ESRD showed significantly decreased VMHC values in the middle occipital gyrus/inferior occipital gyrus,calcarine/lingual/cuneus,precentral gyrus/postcentral gyrus/superior temporal gyrus,and inferior parietal lobule.In contrast,patients with ESRD did not exhibit increased VMHC values in any brain regions.Receiver operating characteristic(ROC)analysis revealed that the areas under the curves for the four brain regions were 0.880,0.878,0.921 and 0.884.Conclusion The results demonstrated that predominantly decreased VMHC in patients with ESRD,which provide preliminary evidence of the potential usefulness of VMHC analyses for the detection of abnormalities of interhemispheric coordination in ESRD.

关 键 词：磁共振成像 脑功能 基于体素镜像同伦连接 终末期肾病 

分 类 号：R445.2[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学]