功能磁共振影像低频振幅对自发性脑出血微创血肿清除术后患者预后的评估价值  

Prognostic Value of Amplitude of Low-frequency Fluctuation in Functional Magnetic Resonance Imaging on Assessing the Prognosis of Patients After Minimally Invasive Hematoma Removal for Spontaneous Cerebral Hemorrhage

作　　者：杨诗友 庄建峰 徐航哲 黄沛钰[6] 俞晓波 张行[1,2,3] 陈高 YANG Shiyou;ZHUANG Jianfeng;XU Hangzhe;HUANG Peiyu;YU Xiaobo;ZHANG Hang;CHEN Gao(Center for Cognition and Brain Disorders,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Institute of Psychological Science,Hangzhou Normal University,Hangzhou 311121,China;Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments,Hangzhou 310015,China;Department of Neurosurgery,Qilu Hospital,Jinan 250063,China;Department of Neurosurgery,the Second Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Radiology,the Second Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]杭州师范大学附属医院脑认知与脑疾病研究中心,浙江杭州310015 [2]杭州师范大学心理科学研究院,浙江杭州311121 [3]浙江省认知障碍评估技术研究重点实验室,浙江杭州310015 [4]山东大学齐鲁医院神经外科,山东济南250063 [5]浙江大学医学院附属第二医院神经外科,浙江杭州310009 [6]浙江大学医学院附属第二医院放射科,浙江杭州310009

出　　处：《杭州师范大学学报（自然科学版）》2022年第4期357-363,共7页Journal of Hangzhou Normal University(Natural Science Edition)

基　　金：国家重点研发计划项目(2018YFC1312600);浙江省医药卫生科技计划项目(2021KY721).

摘　　要：探讨脑活动低频振幅(ALFF)在脑出血患者微创手术恢复后运动功能方面的临床预测价值.选取脑出血患者术前静息态功能磁共振影像及结构像检查的21例患者.经脑出血微创手术随访结果分为Rankin评分高组(定义为恢复好组)10例及Rankin评分低组11例.在术后7 d与术后6个月时分别对21例患者进行Rankin量表检查.采用配对样本t检验,比较术后7 d与术后6个月患者Rankin评分减分率.影像学分析中,在0.01~0.1 Hz的频带上取振幅的平均值,作为给定体素的ALFF并对每个体素的ALFF通过除以全脑ALFF平均值,对有统计学意义的参数值做受试者工作特征(ROC)曲线,分别计算敏感度、特异度及曲线下面积(AUC).通过对减分率高的组进行分析,发现辅助运动区(Supplementary Motor Area)、初级视觉皮层(Primary Visual Cortex)在Rankin高分组与Rankin低分组差异有统计学意义(p<0.01).ROC曲线分析,Rankin对患者术后初级视觉皮层与辅助运动区的AUC分别为0.91,0.82;p值分别为0.01与0.002.本研究提示患者辅助运动区和初级视觉皮层活动对于术后运动相关高级认知功能的恢复有重要作用.The clinical predictive value of low frequency amplitude of brain activity(ALFF)in motor function after recovery from minimally invasive surgery in patients with cerebral hemorrhage was investigated in this study.Twenty-one patients with cerebral hemorrhage who had preoperative resting-state functional magnetic resonance imaging and structural imaging were selected.The results of minimally invasive surgery for cerebral hemorrhage were divided into 10 cases in the high Rankin score group(defined as the good recovery group)and 11 cases in the low Rankin score group.Twenty-one patients were postoperatively examined with Rankin scale after 7 days and 6 months of operations.Paired sample t-test was used to compare the reduction rate of Rankin score between 7 days and 6 months after operation.For imaging analysis,the average of amplitudes in the frequency band from 0.01 to 0.1 Hz was taken as the ALFF for a given voxel,and the ALFF for each voxel was made by dividing the whole-brain ALFF means by the statistically significant parameter values for the subject work characteristic(ROC)curve,so that the sensitivity,specificity and area under the curve(AUC)were calculated,respectively.The analysis of the group with a high rate of subtraction revealed statistically significant differences(p<0.01)in the Supplementary Motor Area and Primary Visual Cortex between the high Rankin group and the low Rankin group.AUC for postoperative primary visual cortex and supplementary motor areas were 0.91 and 0.82,respectively;p-values were 0.01 and 0.002,respectively.The study suggested that the activities of the patients'supplementary motor area and primary visual cortex played an important role in the recovery of motor-related advanced cognitive functions after surgery.

关 键 词：磁共振成像 低频振幅 自发性脑出血 术后预后评估 

分 类 号：R651.1[医药卫生—外科学]