视网膜色素变性磁共振扩散张量成像研究及其与视野相关性分析  

Magnetic resonance diffusion tensor imaging of retinal pigmentosa and its correlation with the visual field

作　　者：彭志优[1] 臧苗苗 范彩媚 李汉林[1] 梁瀛 姜建[2] 邵毅[1] 曾璐瑶 王丽君 易澄 PENG Zhiyou;ZANG Miaomiao;FAN Caimei;LI Hanlin;LIANG Ying;JIANG Jian;SHAO Yi;ZENG Luyao;WANG Lijun;YI Cheng(Department of Ophthalmology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China;Department of Radiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006 [2]南昌大学第一附属医院影像科,江西省南昌市330006

出　　处：《眼科新进展》2022年第12期980-983,988,共5页Recent Advances in Ophthalmology

基　　金：江西省应用研究培育计划(编号:20212BAG70032);江西省重点研发计划(编号:20202BBGL73019);江西省卫计委科技计划项目(编号:202130275,202310019)。

摘　　要：目的使用磁共振扩散张量成像技术(DTI)研究视网膜色素变性(RP)患者的视神经改变及其与视野检查的相关性。方法46例RP患者(RP组)和46例健康对照志愿者(对照组)进行了前瞻性研究。所有受试者进行3.0T MRI-DTI扫描检测,使用简化的小视野扩散张量成像(rFOV-DTI)序列推导出单个视神经的各向异性(FA)、平均弥散系数(MD)、平行扩散系数(λ//)、垂直扩散系数(λ⊥),获得平均分数FA、平均扩散率和特征值图,用于定量分析。进一步分析视野平均偏差(MDVF)与患者的分数FA、平均扩散率、λ//及λ⊥的相关性。结果RP组与对照组受试者间年龄和体质量等差异均无统计学意义(均为P>0.05),而两组之间最佳矫正视力和MDVF差异均具有统计学意义(均为P=0.000)。与对照组相比,RP组患者视神经FA降低,MD、λ//、λ⊥升高,两组之间差异有统计学意义(P<0.001)。RP组患者两侧视神经的FA、MD、λ//和λ⊥与MDVF行相关性分析,视神经FA及λ⊥与MDVF有显著相关性(右侧:r=-0.864、0.719,均为P<0.001;左侧:r=-0.997、r=0.830,均为P<0.001);MD与MDVF不相关(右侧:r=-0.026,P=0.866;左侧:r=-0.115,P=0.445)。结论rFOV-DTI测量值可用于RP患者视神经轴突和髓鞘病变的早期诊断。Objective To evaluate the optic nerve changes of retinitis pigmentosa(RP)patients and their correlation with visual field examination by magnetic resonance imaging-diffusion tensor imaging(MRI-DTI).Methods A prospective study was conducted on 46 RP patients and 46 healthy controls.The 3.0T MRI-DTI was performed for all subjects.The fractional anisotropy(FA),mean diffusivity(MD),parallel diffusion coefficient(λ//)and vertical diffusion coefficient(λ⊥)of a single optic nerve were deduced by using the simplified reduced field-of-view diffusion tensor imaging(rFOV-DTI)sequence,and the mean FA,MD,and eigenvalue graphs were obtained for quantitative analysis.The correlation of mean deviation of visual field(MDVF)with the FA,MD,λ//andλ⊥were further evaluated.Results The comparative analysis of age,body mass,MDVF and best corrected visual acuity(BCVA)of the two groups showed that there was no statistically significant difference in age and body mass(both P>0.05)between the two groups,but there was a statistically significant difference in the BCVA and MDVF(both P<0.001).The statistical analysis of DTI parameters and the degree of visual field defects in RP patients showed that the average FA of the optic nerve was decreased,while the MD,λ//andλ⊥were increased,and the differences between the two groups were statistically significant(all P<0.001).In the RP group,the correction analysis of the mean FA,MD,λ//andλ⊥of the optic nerves on both sides and the MDVF showed that the FA andλ⊥of the optic nerves were significantly associated with the MDVF(right:r=-0.864,P<0.001;r=0.719,P<0.001;left:r=-0.997,P<0.001,r=0.830,P<0.001),while the MD was not correlated with the MDVF(right:r=-0.026,P=0.866;left:r=-0.115,P=0.445).Conclusion The rFOV-DTI measurements can be used as an early diagnostic tool for optic nerve axon and myelin lesions in RP patients,making early intervention in RP patients possible.

关 键 词：视网膜色素变性 视神经 磁共振扩散张量成像 视野 

分 类 号：R774[医药卫生—眼科]