基于静息态功能MRI的鼻咽癌患者放疗后远期脑功能连接变化的研究  

Functional connectivity changes in patients with nasopharyngeal carcinoma long term following radiotherapy:a resting-state functional MRI study

作　　者：宋晓涵 王丽君[1] 吕秀鹏[2] SONG Xiaohan;WANG Lijun;Lü Xiupeng(Department of Radiology,the First Afiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China;Department of Radiotherapy,the First Afiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011 [2]大连医科大学附属第一医院放疗科,辽宁大连116011

出　　处：《实用放射学杂志》2023年第7期1067-1070,共4页Journal of Practical Radiology

基　　金：辽宁省自然科学基金项目(20180550719);辽宁省医学教育研究项目(2022-N005-05)。

摘　　要：目的基于静息态功能磁共振成像(rs-fMRI)探讨鼻咽癌(NPC)患者放疗后远期全脑功能连接(FC)变化。方法选取NPC患者(NPC组)和健康志愿者(对照组)各30例,NPC患者均接受常规放疗,且放疗结束6个月以上。对所有受试者行rs-fMRI检查,使用北京版蒙特利尔认知评估量表(MoCA)进行认知能力评估,统计患者双侧颞叶辐射剂量。结果NPC组的MoCA评分较对照组降低,视空间与执行能力及延迟回忆差异有统计学意义。与对照组相比,NPC组网络内出现3个节点FC降低,分别为右侧岛叶、左侧小脑脚Ⅱ区及右侧楔叶,且右侧岛叶变化具有剂量依赖性;NPC组网络间有4对脑区FC异常,增强及减弱各2对,其中左侧执行控制网络与岛叶网络间FC变化与辐射剂量相关。结论NPC患者放疗后远期出现认知功能降低,rs-fMRI能够显示特定脑区网络内/间FC异常。Objective To investigate the changes of whole brain functional connectivity(FC)in patients with nasopharyngeal carcinoma(NPC)long term following radiotherapy based on resting-state functional magnetic resonance imaging(rs-fMRI).Methods A total of 30 patients with NPC(NPC group)and 30 healthy volunteers(control group)were selected.All NPC patients received conventional radiotherapy,and it was completed for more than 6 months.All subjects were examined with rs-fMRI.The Montreal cognitive assessment(MoCA)was performed to evaluate cognitive ability.The radiation dose of bilateral temporal lobe was counted.Results The MoCA score of NPC group was significantly lower than that of control group,there were statistically significant differences in visuospatial/executive and delayed recall between NPC group and control group.Compared with the control group,NPC group showed three significantly decreased FC in the network,respectively,including the right insula,the left cerebelum crus Ⅱ and the right occipital lobe,and the changes of right insula showed a dose-dependent effect.In NPC group,there were 4 pairs of abnormal FC in brain regions,2 pairs of enhanced and 2 pairs of weakened connections.Moreover,the FC changes between the left executive control network and the insular network was correlated with the radiation dose.Conclusion The cognitive function of NPC patients in the long term decreased following radiotherapy.The abnormal FC within/between specific brain regions are detected via rs-fMRI.

关 键 词：鼻咽癌 静息态功能磁共振成像 功能连接 认知功能 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]