静息态功能MRI观察原发性甲状腺功能减退症患者脑局部一致性及其意义  

Resting-state functional MRI for observation on cerebral regional homogeneity in primary hypothyroidism patients and its significances

作　　者：韩亚兰 黄刚[2] 田利民[3] 秦瑞 曹剑仓 梁丰丽 赵莲萍[2] HAN Yalan;HUANG Gang;TIAN Limin;QIN Rui;CAO Jiancang;LIANG Fengli;ZHAO Lianping(The First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Radiology,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Endocrinology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃省人民医院放射科,甘肃兰州730000 [3]甘肃省人民医院内分泌科,甘肃兰州730000

出　　处：《中国医学影像技术》2022年第7期979-983,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(82060152);甘肃省人民医院院内科研项目(20GSSY3-11)。

摘　　要：目的观察原发性甲状腺功能减退症(甲减)患者静息态功能MRI(rs-fMRI)局部一致性(ReHo)存在差异的脑区,分析其意义。方法对50例首诊未经治疗原发性甲减患者(甲减组)及38名健康志愿者(对照组)行颅脑rs-fMRI,计算ReHo值;观察组间ReHo值差异有统计学意义的脑区,分析甲减组血清甲状腺激素水平与其ReHo值及认知神经心理量表评分之间的相关性。结果甲减组左侧舌回、颞中回、中央前回、中央后回及小脑蚓部ReHo值均较对照组减低(高斯随机多重比较校正后,单个体素P均<0.001,簇大小P均<0.05)。Pearson相关性分析结果显示,甲减组血清促甲状腺激素与蒙特利尔认知评估量表(MoCA)评分(r=-0.259,P=0.037)及左侧舌回ReHo值(r=-0.347,P=0.015)均呈负相关,与汉密尔顿抑郁量表-24项(HAMD-24)评分呈正相关(r=0.313,P=0.011)。结论甲减患者左侧舌回、颞中回、中央前回、中央后回及小脑蚓部ReHo值减低,提示优势半球神经功能活动同步性减低可能是其神经功能受损的重要神经病理生理机制。Objective To observe regional homogeneity(ReHo)using resting-state functional MRI(rs-fMRI)in patients with primary hypothyroidism,and to explore the significances of different ReHo.Methods Totally 50 patients with hypothyroidism(hypothyroidism group)and 38 healthy subjects(control group)underwent rs-fMRI.ReHo values were calculated,the brain areas with different ReHo between groups were identified,and the correlations of the serum thyroid hormone and ReHo of brain areas being significantly different between groups and outcomes of neuropsychological tests were analyzed.Results Compared with control group,decreased ReHo of left lingual gyrus,left middle temporal gyrus,left anterior central gyrus,left posterior central gyrus and cerebellar vermis were observed in hypothyroidism group(after correction with Gauss random field multiple comparison,all single voxel P<0.001,all cluster size P<0.05).Pearson correlation analysis showed that the serum thyroid stimulating hormone levels were negatively correlated with Montreal cognitive assessment(MoCA)score(r=-0.259,P=0.037)and ReHo value of left lingual gyrus(r=-0.347,P=0.015),while positively correlated with Hamilton depression scale-24(HAMD-24)score(r=0.313,P=0.011).Conclusion In patients with hypothyroidism,ReHo values of left lingual gyrus,left middle temporal gyrus,left anterior central gyrus,left posterior central gyrus and cerebellar vermis decreased,suggesting that the decreased synchronicity of dominant hemisphere nerve function might be an important neuropathophysiological mechanism of hypothyroidism.

关 键 词：甲状腺功能减退症 磁共振成像 局部一致性 脑损害 慢性 

分 类 号：R581.2[医药卫生—内分泌] R445.2[医药卫生—内科学]