ASL技术在神经精神性系统性红斑狼疮脑血流灌注异常患者中的应用研究  

Application of ASL technology in patients with abnormal cerebral blood perfusion of neuropsychiatric systemic lupus erythematosus

作　　者：冯艳泓 张鹏 夏建国[2] 张继 徐天野 周文苏 邹红梅 FENG Yan-hong;ZHANG Peng;XIA Jian-guo;ZHANG Ji;XU Tian-ye;ZHOU Wen-su;ZOU Hong-mei(Graduate School of Dalian Medical University,Dalian Liaoning 116044,China;Taizhou People’s Hospital Affiliated to Nanjing Medical University,Taizhou Jiangsu 225300,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]南京医科大学附属泰州人民医院,江苏泰州225300

出　　处：《中国临床医学影像杂志》2023年第7期457-461,共5页Journal of China Clinic Medical Imaging

基　　金：江苏省卫健委科研课题(H2018093);江苏省第五期“333工程”科研项目(BRA2017175)。

摘　　要：目的:通过磁共振动脉自旋标记(Arterial spin labeling,ASL)成像技术研究神经精神性系统性红斑狼疮(Neuropsychiatric systemic lupus erythematosus,NPSLE)患者脑血流灌注的改变模式,并探讨这些改变与其认知功能及临床免疫学指标的相关性。方法:本研究前瞻性的收集自2020年1月—2022年9月到南京医科大学附属泰州人民医院就诊的26例NPSLE患者和27例年龄及教育程度相匹配的健康对照者,两组均采用西门子3.0T磁共振扫描仪进行全脑ASL扫描。采用双样本t检验对两组各脑区CBF值进行统计学分析并评估。之后应用Spearman相关性分析,探索存在血流灌注差异脑区的CBF值与简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分以及临床免疫学指标之间的相关性。结果:与健康对照组相比,NPSLE患者左侧枕中回和左侧梭状回CBF值减低,而右侧岛叶CBF值增加(P<0.05,FWE校正)。相关性分析结果显示左侧梭状回、左侧枕中回CBF值与血清补体C4浓度呈正相关,与IgG呈负相关(r=0.492,P<0.05;r=-0.468,P<0.05;r=0.503,P<0.05;r=-0.486,P<0.05)。左侧梭状回及左侧枕中回的CBF值与MoCA评分呈正相关(r=0.395,P<0.05;r=0.406,P<0.05)。结论:NPSLE患者大脑存在多个脑区的CBF值异常,这些脑区的脑血流灌注改变可能参与了NPSLE患者出现认知障碍的神经生理病理学机制。Objective:To study the pattern of cerebral blood perfusion in patients with neuropsychiatric systemic lupus erythematosus(NPSLE)by magnetic resonance arterial spin labeling(ASL)imaging,and to explore the correlation between these changes and their cognitive function and clinical immunological indicators.Methods:This study prospectively collected 26 NPSLE patients and 27 age-and education-matched health controls who visited Taizhou People’s Hospital Affiliated to Nanjing Medical University from January 2020 to September 2022,both of which were scanned with whole brain ASL using SIEMENS Skyre 3.0T magnetic resonance scanner.A two-sample t-test was used to statistically analyze and evaluate the cerebral blood flow(CBF)values of each brain region in the two groups.Then,Spearman correlation analysis was used to explore the correlation between CBF values in differential brain regions and Mini-Mental State Examination(MMSE)scores,Montreal Cognitive Assessment(MoCA)scores,and clinical immunological indicators.Results:Compared with the health control group,patients with NPSLE had lower CBF values in the left middle occipital gyrus and left fusiform gyrus,while the CBF values of the right insular lobe increased(P<0.05,FWE correction).The correlation analysis results showed that the CBF values of the left fusiform gyrus and the left middle occipital gyrus were positively correlated with serum complement C4 concentration and negatively correlated with IgG.The correlation analysis results showed that the CBF values of the left spindle gyrus and the left middle occipital gyrus were negatively correlated with IgG and positively correlated with serum complement C4 concentration(r=0.492,P<0.05;r=-0.468,P<0.05;r=0.503,P<0.05;r=-0.486,P<0.05).The CBF values of the left fusiform gyrus and the left middle occipital gyrus were positively correlated with the MoCA score(r=0.395,P<0.05;r=0.406,P<0.05).Conclusion:The brains of NPSLE patients have abnormal CBF values in multiple brain regions,and changes in cerebral blood perfusion in th

关 键 词：红斑狼疮 系统性 脑血管循环 磁共振成像 

分 类 号：R593.241[医药卫生—内科学] R338.2[医药卫生—临床医学] R445.2