紧张型头痛患者脑血流量的静息态ASL初步研究  

A preliminary study of cerebral blood flow perfusion based on the ASL in patients with tension type headache in the resting states

作　　者：张诚诚 王吉丽 王亚琦 张淑娴[2] 徐芹艳[2] 孙彤 王锡臻[1] 孙西河[1] ZHANG Chengcheng;WANG Jili;WANG Yaqi;ZHANG Shuxian;XU Qinyan;SUN Tong;WANG Xizhen;SUN Xihe(School of Medical Imaging,Weifang Medical University,Weifang 261031,China;Affiliated Hospital of Weifang Medical University,Weifang 261031,China;Department of Medical Imaging of Weifang Hospital of Traditional Chinese Medicine,Weifang 261031,China)

机构地区：[1]潍坊医学院医学影像学院,潍坊261653 [2]潍坊医学院附属医院影像中心,潍坊261031 [3]潍坊市中医院影像中心,潍坊261031

出　　处：《磁共振成像》2022年第1期76-80,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：山东省自然科学基金(编号:ZR2017MH110)。

摘　　要：目的采用动脉自旋标记(arterial spin labeling,ASL)灌注成像技术探讨紧张型头痛(tension type headache,TTH)患者静息态下脑血流量(cerebral blood flow,CBF)的改变模式及其与疼痛程度的相关性。材料与方法收集自2018年5月至2019年7月到潍坊医学院附属医院就诊的TTH患者31例及与之匹配的健康对照33例,利用三维伪连续动脉自旋标记(3D pseudo-continuous arterial spin labeling,3D-pCASL)灌注成像技术行全脑扫描,分析TTH组及健康对照组的静息态CBF值的差异,并应用视觉模拟评分法(visual analogue scale,VAS)评估TTH组疼痛程度,分析CBF改变与疼痛程度的相关性。结果与健康对照组相比,TTH组患者双侧海马旁回、左侧丘脑、左侧壳核、右侧海马、左侧尾状核、左侧岛叶的CBF值升高;右侧中央后回、右侧岛盖部额下回、左侧额中回的CBF值减低(P<0.05,family-wise error,FWE校正)。另外,左侧豆状壳核、左侧尾状核、右侧海马的CBF值与VAS评分呈正相关(r=0.374,r=0.416,r=0.358,P均<0.05),而右侧岛盖部额下回的CBF值与VAS评分呈负相关(r=-0.444,P<0.05)。结论TTH患者的大脑存在多个CBF值异常的脑区,这些脑区的脑血流改变可能参与了TTH的病理生理机制。Objective:To investigate the alteration patterns of cerebral blood flow(CBF)based on arterial spin labeling(ASL)and its correlation with the degree of pain in patients with tension type headache in the resting states.Materials and Methods:Thirty-one cases of tension-type headache patients and 33 cases of matched healthy control volunteers were collected from May 2018 to July 2019 in Affiliated Hospital of Weifang Medical University.A three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL)imaging was performed to measure CBF in the resting-states.The difference of CBF between tension headache group and healthy control group was analyzed,visual analogue scale(VAS)was used to evaluate the degree of pain in TTH group,and the correlation between the brain region with altered CBF values and pain degree was evaluated in tension headache patients.Results:Compared with the healthy control group,the CBF values of bilateral parahippocampal gyrus,left thalamus,left putamen,right hippocampus,left caudate nucleus,left insular lobe in TTH group increased,while the CBF values of right central posterior gyrus,right inferior frontal gyrus of insular tectum and left middle frontal gyrus decreased(P<0.05,family-wise error,FWE correction).In addition,the CBF values of left lenticular putamen,left caudate nucleus and right hippocampus were positively correlated with VAS scores(r=0.374,r=0.416,r=0.358,P<0.05),while the CBF values of right inferior frontal gyrus were negatively correlated with VAS scores(r=-0.444,P<0.05).Conclusion:Tension-type headache patients had multiple brain regions with altered CBF value,which may be involved in the central pathophysiological mechanism of tension type headache.

关 键 词：紧张型头痛 脑血流量 动脉自旋标记 灌注成像 磁共振成像 疼痛程度 相关分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.041[医药卫生—诊断学]