基底节区扩大血管周围间隙对基底节萎缩的预测价值研究  

Value of dilated Virchow-Robin spaces in the basal ganglia in predicting basal ganglia atrophy

作　　者：周群[1] 李月峰[1] 朱彦[1] 徐宇浩[2] Zhou Qun;Li Yuefeng;Zhu Yan;Xu Yuhao(Department of Imaging,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China;Department of Neurology,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院影像科,镇江212001 [2]江苏大学附属医院神经内科,镇江212001

出　　处：《中华神经医学杂志》2022年第10期996-1002,共7页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金(82101431);江苏省卫生健康委医学科研项目(H2019055);镇江市社会发展项目(SH2020023)。

摘　　要：目的探讨基底节区扩大血管周围间隙(dVRS)对基底节萎缩的预测价值。方法选择自2015年5月1日至2016年4月30日于江苏大学附属医院行头颅MRI检查证实存在基底节区dVRS的164例患者纵向随访5年, 最终纳入120例患者进行分析。应用3.0T MRI观察患者基底节体积情况, 并根据基底节是否萎缩将患者分为正常组(n=82)和萎缩组(n=38)。比较正常组与萎缩组患者间一般资料及基底节区dVRS等级的差异, 比较不同基底节区dVRS等级患者间基线期、5年后基底节体积以及基线期与5年后基底节体积差值(△基底节体积)的差异, 采用Spearman相关分析评估△基底节体积与基底节区dVRS等级间的相关性, 采用多因素Logistics回归分析筛选基底节萎缩的独立影响因素, 并绘制受试者工作特征(ROC)曲线评估各独立影响因素及其联合对基底节萎缩的预测价值。结果萎缩组患者的年龄、糖尿病史比例及基底节区dVRS等级均较正常组明显增高, 差异均有统计学意义(P<0.05)。不同基底节区dVRS等级患者间基线期、5年后基底节体积及△基底节体积的差异均有统计学意义(P<0.05), 其中△基底节体积随着基底节区dVRS等级的增加而逐渐增加。相关性分析显示△基底节体积与基底节区dVRS等级呈正相关性(rs=0.695, P<0.001);在对年龄、糖尿病史进行协因素校正后仍具有正相关性(rs=0.667, P<0.001)。多因素Logistics回归显示年龄(OR=1.776, 95%CI:1.372~2.141, P=0.008)、糖尿病史(OR=1.513, 95%CI:1.129~1.954, P=0.011)和基底节区dVRS等级(OR=2.855, 95%CI:2.367~3.283, P=0.006)为基底节萎缩的独立影响因素。基底节区dVRS等级单独预测基底节萎缩的ROC曲线下面积为0.709(95%CI:0.611~0.792, P<0.001), 灵敏度为61.89%, 特异度为83.59%;年龄、糖尿病、基底节区dVRS等级联合预测基底节萎缩的ROC曲线下面积为0.783(95%CI:0.687~0.878, P<0.001), 灵敏度为73.68%, 特异度为85.19%。结论基底Objective To explore the value of dilated Virchow-Robin spaces(dVRS)in the basal ganglia in predicting basal ganglia atrophy.Methods A total of 120 patients accepted head MRI and conformed as having dVRS in the basal ganglia in our hospital from May 1,2015 to April 30,2016 were chosen in our study;these patients were followed up for 5 years.The basal ganglia volume was observed by 3.0T MRI;according to whether the basal ganglia had atrophy or not,these patients were divided into normal group(n=82)and atrophy group(n=38).The general data and dVRS grading between the normal group and the atrophy group were compared.The basal ganglia volume at baseline and 5 years later in patients with different dVRS grading and the difference value of basal ganglia volume at baseline and 5 years later(△basal ganglia volume)were recorded for comparative analysis.Spearman analysis was used to evaluate the correlation between△basal ganglia volume and dVRS grading.Independent influencing factors for basal ganglia atrophy were analyzed by Logistics regression;receiver operating characteristic(ROC)curve was drawn to evaluate the predictive values of independent influencing factors and their combination in basal ganglia atrophy.Results Patients in the atrophy group had significantly older age,significantly higher percentage of patients with diabetes history,and significantly higher dVRS grading in the basal ganglia than those in the normal group(P<0.05).There were significant differences in basal ganglia volume and△basal ganglia volume at baseline and 5 years later among patients with different dVRS grading(P<0.05);△basal ganglia volume gradually increased with the increase of dVRS grading.Correlation analysis showed that△basal ganglia volume was positively correlated with dVRS grading in basal ganglia(rs=0.695,P<0.001);after adjusting for age and history of diabetes,the correlation was still positive(rs=0.667,P<0.001).Logistics regression showed that age(OR=1.776,95%CI:1.372-2.141,P=0.008),diabetes history(OR=1.513,95%CI:1.129

关 键 词：扩大血管周围间隙 基底节 萎缩 预测价值 

分 类 号：R741[医药卫生—神经病学与精神病学]