儿童抽动障碍弥散张量成像技术成像特点与耶鲁抽动严重程度量表评估的相关性研究  

Correlation study of imaging characteristics of diffusion tensor imaging and the Yale Global Tic Severity Scale in children with tic disorders

作　　者：贾倩芳 李习婉 李沙沙 张梦 马丙祥[2] Jia Qianfang;Li Xiwan;Li Shasha;Zhang Meng;Ma Bingxiang(Department of Child Rehabilitation,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China;Department of Pediatrics,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]新乡医学院第一附属医院儿童康复科,卫辉453100 [2]河南中医药大学第一附属医院儿科,郑州450000

出　　处：《中华实用儿科临床杂志》2023年第8期586-590,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210516)。

摘　　要：目的:探讨儿童抽动障碍影像学与耶鲁抽动严重程度量表(YGTSS)评估的相关性。方法:回顾性研究。选择2022年1月至2023年3月新乡医学院第一附属医院儿童康复科收治的抽动障碍患儿33例(抽动障碍组),同期体检健康儿童10例(健康对照组)。在功能磁共振成像(fMRI)技术的功能定位下寻找不同程度抽动障碍患儿的活跃区域,选择感兴趣区(ROI),进行定位监测及弥散张量成像(DTI)技术扫描评估,记录表观弥散系数(ADC)值与分数各项异性(FA)值,健康对照组儿童也选择与抽动障碍组的统一ROI(双侧丘脑、膝部、压部、苍白球、尾状核),进行ADC值与FA值的收集,对所得数据进行独立样本t检验,并与YGTSS进行严重程度Pearson相关性分析。结果:2组ADC值比较,双侧丘脑(左侧0.869±0.077比0.794±0.083,右侧0.853±0.055比0.798±0.054)与双侧尾状核(左侧0.871±0.121比0.787±0.052,右侧0.856±0.075比0.788±0.063)数值差异均有统计学意义(左侧丘脑P=0.022,右侧丘脑P=0.014,左侧尾状核P=0.003,右侧尾状核P=0.010),余ROI的ADC值差异均无统计学意义(均P>0.05)。2组FA值比较,双侧丘脑(左侧0.259±0.050比0.344±0.077,右侧0.265±0.057比0.347±0.095)与右侧尾状核(0.168±0.118比0.309±0.181)数值差异有统计学意义(左侧丘脑P=0.007,右侧丘脑P=0.026,右侧尾状核P=0.041)。抽动障碍组患儿轻中度组ADC值、FA值比较,差异均无统计学意义(均P>0.05)。抽动障碍组患儿ADC值与YGTSS评分相关性分析显示,左侧丘脑与右侧尾状核ADC值与YGTSS评分呈正相关(r=0.407、0.372,均P<0.05)。抽动障碍组患儿FA值与YGTSS评分相关性分析显示,右侧丘脑FA值与YGTSS评分呈负相关(r=-0.439,P<0.05)。结论:丘脑与尾状核ADC值、右侧丘脑FA值与抽动障碍患儿YGTSS评分相关,左侧丘脑与右侧尾状核ADC值越高,YGTSS评分越高,患儿抽动症状越重;右侧丘脑FA值越大,YGTSS评分越低,患儿抽动症状越轻。ObjectiveTo explore the correlation between imaging features of children with tic disorders and their features assessed by the Yale Global Tic Severity Scale(YGTSS).MethodsA retrospective study.A total of 33 children with tic disorders treated in the Department of Child Rehabilitation,the First Affiliated Hospital of Xinxiang Medical University from January 2022 to March 2023 were included in the tic disorder group,and 10 healthy age-matched children received physical examination during the same period were included in the healthy control group.Under the functional positioning of functional magnetic resonance imaging(fMRI),the active area of children with tic disorders at varying degrees was found.In the region of interest(ROI),localization monitoring and diffusion tensor imaging(DTI)were performed,and the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)were recorded.In the same ROI(bilateral thalamus,genu of internal capsule,splenium of corpus callosum,globus pallidus,caudate nucleus)of children in healthy control group,ADC and FA were recorded.Imaging data were compared between groups using the independent sample t test,and their correlation with YGTSS scores was identified by the Pearson correlation analysis.ResultsThere were significant differences in ADC of the left thalamus(0.869±0.077 vs.0.794±0.083,P=0.022),the right thalamus(0.853±0.055 vs.0.798±0.054,P=0.014),the left caudate nucleus(0.871±0.121 vs.0.787±0.052,P=0.003)and the right caudate nucleus(0.856±0.075 vs.0.788±0.063,P=0.010)between tic disorder group and healthy control group.No significant differences were detected in ADC of the remaining ROI between groups(all P>0.05).There were significant differences in FA of the left thalamus(0.259±0.050vs.0.344±0.077,P=0.007),the right thalamus(0.265±0.057 vs.0.347±0.095,P=0.026)and the right caudate nucleus(0.168±0.118 vs.0.309±0.181,P=0.041)between tic disorder group and healthy control group.No significant differences were detected in ADC and FA between children with mild a

关 键 词：抽动障碍 弥散张量成像技术 耶鲁抽动严重程度量表 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]