多延迟动脉自旋标记评估甲状腺相关眼病患者脑灌注改变的研究  

Brain perfusion alterations in patients with thyroid-associated ophthalmopathy:a study based on multi-delay arterial spin labeling

作　　者：陈文[1] 胡昊[1] 陈欢欢[2] 刘虎[3] 吴倩[1] 陈露 周江 许晓泉[1] 吴飞云[1] CHEN Wen;HU Hao;CHEN Huanhuan;LIU Hu;WU Qian;CHEN Lu;ZHOU Jiang;XU Xiaoquan;WU Feiyun(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Ophthalmology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学第一附属医院内分泌科,江苏南京210029 [3]南京医科大学第一附属医院眼科,江苏南京210029

出　　处：《实用放射学杂志》2023年第6期895-899,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81801659);江苏省人民医院临床能力提升工程项目(JSPHMC-2021-8)。

摘　　要：目的探讨多延迟动脉自旋标记(ASL)在评估甲状腺相关眼病(TAO)患者脑灌注改变中的价值。方法前瞻性选取25例TAO患者作为TAO组,18例健康志愿者作为健康对照(HC)组。所有受试者均行多延迟ASL检查。计算脑血流量(CBF)、动脉传输时间(ATT)和脑动脉血容量(aCBV)图像。分析脑灌注参数的组间差异及其与临床指标的相关性。结果相较于HC组,TAO组左侧舌回/梭状回CBF减低,左侧中央后回、双侧额上内侧回CBF增高,右侧额上回/额中回、右侧颞极/岛叶、左侧颞中回/颞下回ATT减低,左侧舌回/梭状回、右侧颞极aCBV减低。TAO组右侧颞极/岛叶的ATT与视力呈显著正相关(r=0.429,P=0.032),右侧颞极的aCBV与视力呈显著正相关(r=0.407,P=0.044)。结论多延迟ASL显示了TAO患者广泛的脑灌注异常,提示视觉、情绪及认知相关脑区的功能损伤和重塑。Objective To investigate the value of multi-delay arterial spin labeling(ASL)in evaluating brain perfusion alterations in patients with thyroid-associated ophthalmopathy(TAO).Methods A total of 25 TAO patients as TAO group,and 18 healthy volunteers as healthy control(HC)group were prospectively selected.All subjects underwent multi-delay ASL scans.Cerebral blood flow(CBF),arterial transit time(ATT)and arterial cerebral blood volume(aCBV)maps were calculated.The inter-group differences of brain perfusion parameters and their relationships with clinical indices were analyzed.Results Compared with HC group,TAO group showed decreased CBF in the left lingual gyrus/fusiform gyrus,while increased CBF in the left postcentral gyrus and the bilateral medial superior frontal gyrus.In addition,TAO group showed decreased ATT in the right superior frontal gyrus/middle frontal gyrus,the right temporal pole/insula and the left middle temporal gyrus/inferior temporal gyrus.Moreover,TAO group exhibited decreased aCBV in the left lingual gyrus/fusiform gyrus and the right temporal pole.In TAO group,ATT in the right temporal pole/insula showed significant positive correlation with visual acuity(r=0.429,P=0.032),and aCBV in the right temporal pole showed significant positive correlation with visual acuity(r=0.407,P=0.044).Conclusion Multi-delay ASL shows extensive brain perfusion abnormalities in TAO patients,indicating the functional impairment and remodeling of visual-,emotional-,and cognitive-related regions.

关 键 词：甲状腺相关眼病 脑血流量 动脉自旋标记 

分 类 号：R777.5[医药卫生—眼科] R749[医药卫生—临床医学] R445.2