正常眼压性青光眼患者大脑皮层微结构损伤的扩散峰度成像研究  

Diffusion kurtosis imaging study of cerebral cortex microstructure damage in patients with normal tension glaucoma

作　　者：李婷[1] 曲晓霞 王倩[1] 鲜军舫[1] LI Ting;QU Xiaoxia;WANG Qian;XIAN Junfang(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730

出　　处：《磁共振成像》2022年第11期6-11,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:81871340、82071906、81571649、81701666、81901719);北京市医院管理局临床医学发展专项(编号:ZYLX201704);北京市医院管理中心“登峰”计划专项(编号:DFL20190203)。

摘　　要：目的 采用扩散峰度成像(diffusion kurtosis imaging, DKI)研究正常眼压性青光眼(normal tension glaucoma,NTG)大脑皮层微结构的改变特点,为进一步阐明NTG脑皮质改变机制提供影像学依据。材料与方法 分析2016年11月至2020年5月于我院就诊的37例NTG患者及37例健康志愿者的DKI数据,使用人类连接计划多模态分割图谱提取两组受试者44个脑区的各向异性分数(fractional anisotropy, FA)、平均峰度(mean kurtosis, MK)、辐射峰度(radial kurtosis, RK)及轴向峰度(axial kurtosis, AK),采用双样本t检验比较组间差异,并分析NTG患者出现异常脑区的DKI参数与视野平均缺损的相关性。结果 NTG患者双侧岛叶及额叶岛盖、颞顶枕连接区、顶上小叶、顶下小叶、前扣带回及内侧前额叶、左侧背外侧前额叶、右侧视觉通路腹侧流、视觉外侧纹状体的颞中区(middle temporal comlpex,MT+区)及邻近视皮层、初级听皮层FA值减低(P<0.05,FDR校正);右侧MT+区及邻近视皮层MK值减低(P=0.0134,FDR校正);全脑RK值与正常对照受试者相比差异无统计学意义(P>0.05,FDR校正);双侧MT+区及邻近视皮层、岛叶和额叶岛盖、前扣带回和内侧前额叶、左侧顶下小叶、眶回及额极、右侧视觉通路腹侧流、颞顶枕连接区AK值减低(P<0.05,FDR校正)。双侧颞顶枕连接区、右侧前扣带回和内侧前额叶的FA值与双眼视野平均缺损值呈正相关,左侧前扣带回及内侧前额叶、右侧视觉通路腹侧流的FA值与左眼视野平均缺损值呈正相关,右侧岛叶及额叶岛盖FA值与右眼视野平均缺损值呈正相关(P<0.05)。结论 DKI可以检测NTG患者视觉皮层、突显网络相关皮层、默认网络相关皮层、背侧注意网络相关皮层、颞顶枕连接区、初级听皮层及眶回及额极的多发微结构损伤,FA值可反映脑微结构损伤与患者疾病严重程度的关系,是潜在的生物学指标。Objective: Diffusion kurtosis imaging(DKI) was used to study the cerebral cortical microstructure alterations of normal tension glaucoma(NTG), so as to provide imaging evidence for further elucidating the mechanism of cerebral cortical alterations in NTG. Materials and Methods: The DKI data of 37 NTG patients who were diagnosed in our hospital and 37 healthy control subjects recruited from November 2016 to May 2020 were analyzed. The fractional anisotropy(FA), mean kurtosis(MK), radial kurtosis(RK)and axial kurtosis(AK) of 44 brain regions of the two groups of subjects were extracted using the Human Connectome Project multimodal parcellation atlas. The differences between the two groups were compared using the student t-test. Afterwards, the correlations between the DKI parameters of abnormal brain areas and the mean defect of visual field in NTG patients were analyzed.Results: In NTG patients, the FA values of bilateral insula and frontal opercular, temporoparietal occipital junction, superior parietal lobule, inferior parietal lobule, anterior cingulate gyrus and medial prefrontal lobe, left dorsolateral prefrontal lobe, right ventral stream of visual pathway, middle temporal complex(MT+) with neighboring visual areas, and early auditory cortex decreased(P<0.05, FDR correction). The MK value of MT+ complex with neighboring visual areas decreased(P=0.0134, FDR correction). There was no significant difference between the RK values of NTG patients and those of the normal control subjects in the whole brain(P>0.05, FDR correction). AK values decreased in bilateral MT+ complex with neighboring visual areas, insular lobe and frontal opercular, anterior cingulate gyrus and medial prefrontal lobe, left inferior parietal lobule, orbital gyrus and frontal pole, right ventral stream of visual pathway, and temporoparietal occipital junction(P<0.05, FDR correction). The FA values of bilateral temporoparietal occipital junction,right anterior cingulate gyrus and medial prefrontal lobe were positively correlated with the mean

关 键 词：正常眼压性青光眼 脑 神经退行性变 磁共振成像 扩散峰度成像 扩散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R775[医药卫生—诊断学]