基于VBM分析儿童急性淋巴细胞白血病患者化疗后脑灰质体积变化与认知功能的相关性  

Correlation between changes of gray matter volume and cognitive function in acute lymphoblastic leukemia children after chemotherapy based on VBM analysis

作　　者：李方玲 郭义敏 徐高强 刘颖 张体江 陈晓曦 LI Fangling;GUO Yimin;XU Gaoqiang;LIU Ying;ZHANG Tijiang;CHEN Xiaoxi(Department of Radiology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Pediatrics,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Pediatrics,Guizhou Chlidren's Hospital,Zunyi 563000,China)

机构地区：[1]遵义医科大学附属医院放射科,遵义563000 [2]遵义医科大学附属医院儿内二科,遵义563000 [3]贵州省儿童医院小儿内科,遵义563000

出　　处：《磁共振成像》2023年第1期72-76,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：贵州省省级科技计划项目(编号:黔科合基础[2020]1Y347、黔科合基础[2020]1Y346)。

摘　　要：目的采用基于体素的形态测量学方法(voxel-based morphometry,VBM)分析儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患者化疗后脑灰质体积变化,探讨儿童ALL患者脑灰质体积变化与认知功能的相关性。材料与方法收集2021年3月至2022年7月在遵义医科大学附属医院就诊的ALL经治儿童20例(ALL组),所有患者均按照中国儿童白血病组(theChineseChildhoodLeukemiaGroup,CCLG)-ALL2008和2018版本方案以及中国儿童肿瘤协作组(theChinese Children’s Cancer Group,CCCG)-ALL 2015版本方案完成化疗。同期招募20名健康对照组儿童。所有受试者均行3D-T1WI结构像全脑扫描,并采用中国韦氏儿童智力量表第四版对受试者进行认知功能评估。应用VBM技术比较两组灰质体积差异,提取差异脑区灰质体积,以年龄作为协变量与认知功能结果进行偏相关分析。结果与对照组相比,ALL组额叶(右眶部额下回、右额中回、右额上回)、颞叶(左颞中回)、顶叶(左中央后回)、枕叶(双侧舌回)、右海马灰质体积减小(P<0.05,FDR校正);ALL组灰质体积改变与其认知功能无明显相关(P均>0.05)。结论儿童期ALL患者化疗结束后存在多个脑区灰质体积减小,但这些区域体积改变与其认知功能缺乏相关性。Objective:To analyze the changes of brain gray matter volume in children with acute lymphoblastic leukemia(ALL)after chemotherapy through voxel-based morphometry(VBM),and to explore the correlation between changes in brain gray matter volume and cognitive function in children with ALL.Materials and Methods:A total of 20 children with ALL treated in Affiliated Hospital of Zunyi Medical University were enrolled from March 2021 to July 2022,and all patients completed chemotherapy according to the Chinese Childhood Leukemia Group(CCLG)ALL protocol(version:2008 and 2018)and Chinese Children’s Cancer Group(CCCG)ALL protocol(version:2015).During the same period,20 healthy control children were recruited.All subjects underwent 3-dimensional-T1-weighted MR brain images scan,and Chinese Wechsler Intelligence Scale for Children-4th Edition was used to evaluate their cognitive function.Results:Compared with the control group,the gray matter volume of right orbital inferior frontal gyrus,right middle frontal gyrus,right superior frontal gyrus,left middle temporal gyrus,left postcentral gyrus,bilateral lingual gyrus and right hippocampal gyrus decreased in the ALL group(P<0.05,FDR correction).In ALL group,gray matter volume of above areas values revealed no significant correlation with the cognitive function parameters(all P>0.05).Conclusions:Childhood ALL patients after chemotherapy have multiple brain regions with reduced gray matter volume,but these changes lack association with patients’cognitive function.

关 键 词：急性淋巴细胞白血病 儿童 磁共振成像 基于体素的形态测量学方法 认知功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R733.71[医药卫生—诊断学]