纤维束自动定量法对急性期轻度脑外伤后白质完整性受损的研究  

The Value of Automating Fiber-Quantification in Detecting White Matter Injury in Patients with Acute Mild Traumatic Brain Injury

作　　者：王田尧 刘军 王伊凡 马骏峰[2] WANG Tianyao;LIU Jun;WANG Yifan;MA Junfeng(Department of Radiology,Shanghai Fith People's Hospital,Fudan University;Department of Neurosurgery,Shanghai Fith People's Hospital,Fudan University)

机构地区：[1]复旦大学附属上海市第五人民医院放射科,上海200240 [2]复旦大学附属上海市第五人民医院脑外科

出　　处：《中国医学计算机成像杂志》2022年第6期574-578,共5页Chinese Computed Medical Imaging

基　　金：上海市闵行区自然科学基金(2018MHZ088);上海市闵行区医学特色专科建设-扶持专科项目(2020MWFC01)。

摘　　要：目的:探讨纤维束自动定量法(AFQ)在轻度脑外伤(mTBI)患者急性期早期脑白质结构损伤的应用价值,研究mTBI患者的白质纤维结构特征和认知功能损伤的相关性。方法:将50例急性期mTBI患者和38例性别、年龄匹配的健康志愿者纳入本研究,采集弥散张量成像(DTI)数据和认知功能评分资料,采用AFQ技术分析DTI数据,比较两组被试的白质纤维束的差异,采用双样本t检验和错误发现率(FDR)校正,并将mTBI人群受损纤维节段的指标与被试的认知功能评分进行相关性分析。结果:与健康对照组相比,mTBI患者组中胼胝体小钳(27~41段)的各向异性分数(FA)值显著减低(PFDR<0.05),同时mTBI组在信息处理速度[模式对比处理速度测验(PCPST):F=3.238,P=0.044;阅读数字符号测验(OSDT):F=5.697,P=0.005]、情景记忆[图片顺序记忆测验(PSMT):F=4.767,P=0.011]以及即刻记忆[Rey听觉词语测验(Rey-AVLT):F=6.223,P=0.003]等多项认知评估中显著降低;mTBI组胼胝体小钳受损亚节段的FA值与信息处理速度测验的PCPST评分呈正相关(r=0.343,P=0.018)。结论:利用AFQ技术能够更加准确发现mTBI患者急性期脑白质纤维束完整性损伤的情况,在评估急性期mTBI患者认知功能损伤的临床应用中有很高的价值。Purpose:To investigate the application value of automating fiber-tract quantification(AFQ)in detecting the white matter injury in patients with mild traumatic brain injury(mTBI),and to study the correlation between white matter injury and cognitive impairment.Methods:Fifty patients with acute mTBI and 38 gender-and age-matched healthy volunteers were enrolled,and their diffusion tensor imaging(DTI)data and scores on cognitive function were collected.DTI data was analyzed using AFQ technology,and the difference of the white matter fiber tracts of the two groups were compared with the two-sample t-test and corrected by false discovery rate(FDR)control,and the correlation between the damaged fiber segment of the mTBI and the cognitive function score was analyzed.Results:Compared with the healthy control,in the mTBI,the fractional anisotropy(FA)value of the corpus callosum(segment 27-41)was significantly reduced(PFDR<0.05),and the scores on information processing speed[pattern comparison processing speed test(PCPST):F=3.238,P=0.044;oral symbol digit test(OSDT):F=5.697,P=0.005],episodic memory[picture sequence memory test(PSMT):F=4.767,P=0.011]and immediate memory[Rey’s auditory verbal learning test(Rey-AVLT):F=6.223,P=0.003]were significantly lower.The FA value of the damaged subsegment of the corpus callosum in the mTBI was positively correlated with the PCPST score(r=0.343,P=0.018).Conclusion:The AFQ analysis method can be used to more accurately detect the damaged segments of the acute white matter fiber bundle in mTBI patients,and it can provide the high clinical evaluation in acute mTBI patients with cognitive impairment.

关 键 词：轻度脑外伤 纤维束自动定量法 弥散张量成像 脑白质纤维束 认知功能损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]