基于扩散张量成像的原发性失眠患者脑白质微结构变化研究  

Diffusion tensor imaging study on white matter microstructural changes in patients with primary insomnia

作　　者：韩文轩 何修勇 段王栋 卢治兰 王慧[3] 李海宁[1] 周元平 陈巍 HAN Wenxuan;HE Xiuyong;DUAN Wangdong;LU Zhilan;WANG Hui;LI Haining;ZHOU Yuanping;CHEN Wei(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an2710061,China;Department of Imaging,Ankang Hospital of Traditional Chinese Medicine,Ankang,Shanci Province 725000,China;School of Future Technology,Xi'an Jiaotong University,Xi'an 710000,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]安康市中医医院影像科,陕西安康725000 [3]西安交通大学未来技术学院,陕西西安710000

出　　处：《实用放射学杂志》2023年第7期1051-1054,共4页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划项目(2020JM-703)。

摘　　要：目的探讨原发性失眠(PI)患者脑白质微结构的改变及其与临床症状的相关性。方法使用基于纤维束示踪的空间统计学方法(TBSS)定量分析25例PI患者(PI组)与23例健康志愿者(对照组)的扩散张量成像(DTI)相关指标的差异,采用受试者工作特征(ROC)曲线分析有差异指标鉴别PI组与对照组的诊断效能。进一步提取感兴趣区(ROI)的扩散参数与患者的量表评分进行相关分析。结果PI组右侧放射冠、内囊以及大脑脚的各向异性分数(FA)低于对照组(P<0.05);右侧内囊前肢及上放射冠的FA值鉴别PI组与对照组的曲线下面积(AUC)最大,为0.751(P<0.05)。相关分析表明,上述纤维束的FA值与匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)评分之间存在显著负相关(P<0.05)。结论PI患者脑白质微结构完整性的降低主要位于右侧放射冠、内囊以及大脑脚区域,为研究PI的神经病理学特征提供了影像学依据。Objective To explore the microstructural changes of white matter in patients with primary insomnia(PI)and its correlation with clinical symptoms.Methods The differences of diffusion tensor imaging(DTI)related indexes between 25 patients with PI(PI group)and 23 healthy volunteers(control group)were quantitatively analyzed via tract-based spatial statistics(TBSS).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic performance of different indexes in differentiating PI group from control group.The diffusion parameters extracting from the region of interest(ROI)were further correlated with the scale scores of patient with PI.Results The fractional anisotropy(FA)of the right corona radiata,internal capsule and cerebral peduncle in PI group was significantly lower than those of control group(P<0.05).The area under the curve(AUC)of FA values of the right anterior limb of the internal capsule and superior corona radiata in differentiating PI group from control group was the largest one,which was 0.751(P<0.05).Correlation analysis showed a significant negative correlation between the FA value of the above fiber tracts and the scores of Pittsburgh sleep quality index(PSQI)and Hamilton anxiety scale(HAMA),respectively(P<0.05).Conclusion The reduced microstructural integrity of the white matter in patients with PI is mainly located in the right corona radiata,internal capsule and cerebral peduncle,which provides an imaging basis for studying the neuropathological characteristics of PI.

关 键 词：原发性失眠 脑白质 扩散张量成像 

分 类 号：R256.23[医药卫生—中医内科学] R445.2[医药卫生—中医学]