轻度创伤性颅脑损伤患者丘脑扩散峰度成像研究  

Diffusion Kurtosis Imaging of Thalamus in Patients with Mild Traumatic Brain Injury

作　　者：汪丽娜 肖勇 WANG Li’na;XIAO Yong(Jiangsu Vocational College of Medicine,Yancheng City,Jiangsu Province 224005)

机构地区：[1]江苏医药职业学院医学影像学院,江苏省盐城市224005 [2]徐州医科大学盐城临床学院、盐城市第一人民医院

出　　处：《医学理论与实践》2023年第10期1621-1623,1628,共4页The Journal of Medical Theory and Practice

基　　金：盐城市医学科技发展计划项目(YK2018014)。

摘　　要：目的:探讨轻度创伤性颅脑损伤(mTBI)后患者丘脑微结构变化特点,并分析其与损伤后认知功能减退的相关性。方法:采集27例mTBI患者(mTBI组)和22例健康志愿者(健康对照组)扩散峰度成像(DKI)数据,采用DKE软件后处理得到平均峰度(MK)、轴向峰度(AK)、径向峰度(RK)、各向异性分数(FA)、平均扩散率(MD)参数图,再提取双侧丘脑各参数均值,比较两组间各参数差异。分析mTBI组双侧丘脑各参数值与蒙特利尔认知评估量表(MoCA)评分相关性。结果:与健康对照组相比,mTBI组MoCA总评分及各子评分均有下降,差异有统计学意义(P<0.05);与健康对照组比较,mTBI组双侧丘脑MK、AK、RK值减低,MD值升高,差异有统计学意义(P<0.05),而两组间FA值差异无统计学意义(P>0.05);Pearson相关性分析显示,mTBI组双侧丘脑MK、AK、RK、MD值与MoCA总评分、视空间与执行能力、记忆力、注意力、语言能力评分均有相关性(P<0.05);FA值与各临床特征因子均无明显相关性(P>0.05)。结论:DKI成像技术可以敏感检出mTBI患者丘脑微结构损害,丘脑MK、MD值对早期评估mTBI患者脑内永久性损害程度以及认知障碍有一定参考价值。Objective:To investigate the characteristics of thalamic microstructure changes in patients with mild traumatic brain injury(mTBI),and to analyze the correlation between the changes and cognitive impairment after mTBI.Methods:The diffusion kurtosis imaging(DKI)data of 27 patients with mTBI(mTBI group)and 22 healthy volunteers(healthy control group)were collected.The parameter maps of mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),anisotropy fraction(FA)and mean diffusion rate(MD)were obtained by post processing of DKE software,and then the mean values of parameters of bilateral thalamus were extracted to compare the differences between the two groups.To analyze the correlation between the parameters of bilateral thalamus and the score of Montreal Cognitive Assessment Scale(MoCA)in mTBI group.Results:Compared with the healthy control group,the total MoCA score and each sub score in the mTBI group decreased,with a statistically significant difference(P<0.05).Compared with healthy control group,MK,AK,and RK values in both thalamus of mTBI group decreased,while MD values increased,with a statistically significant difference(P<0.05).However,there was no statistically significant difference in FA values between the two groups(P>0.05).Pearson correlation analysis showed that the MK,AK,RK,MD values of bilateral thalamus in the mTBI group were correlated with the total MoCA score,visual space and executive ability,memory,attention,and language ability scores(P<0.05),there was no significant correlation between FA and clinical characteristic factors(P>0.05).Conclusion:DKI imaging technology can sensitively detect thalamic microstructure damage in mTBI patients.Thalamic MK and MD values have certain reference value for early assessment of permanent brain damage and cognitive impairment in mTBI patients.

关 键 词：轻型颅脑损伤 扩散峰度成像 蒙特利尔认知评估量表 

分 类 号：R651.15[医药卫生—外科学]