基于DKI技术对系统性红斑狼疮患者脑白质微结构改变的研究  

A Study on The Microstructure Changes of White Matter in Patients with Systemic Lupus Erythematosus Based on DKI Technology

作　　者：张鹏 周文苏 孙中茹 李瑗[2] 夏建国[2] 邹红梅[3] ZHANG Peng;ZHOU Wensu;SUN Zhongru(Graduate School of Dalian Medical University Liaoning,Dalian,Liaoning Province 116044,P.R.China)

机构地区：[1]大连医科大学研究生院 [2]泰州市人民医院影像科 [3]泰州市人民医院风湿免疫科

出　　处：《临床放射学杂志》2023年第10期1546-1551,共6页Journal of Clinical Radiology

基　　金：江苏省卫健委科研课题项目(编号:H2018093);江苏省第五期“333工程”科研项目(编号:BRA2017175);泰州市人民医院院级科研基金项目(编号:ZL202017)。

摘　　要：目的应用扩散峰度成像(DKI)技术中基于纤维束的空间统计分析方法(TBSS)探讨系统性红斑狼疮(SLE)患者脑白质结构的改变及其与神经精神量表的相关性。方法选取41例女性SLE患者(SLE组)及45名与其年龄、性别及教育程度相匹配健康志愿者(HC组)进行DKI检查,测定有统计学差异脑区的各向异性分数(FA)、平均扩散系数(MD)、平均扩散峰度(MK)间的差异,并采用Spearman相关性分析来探讨差异脑区FA、MD及MK值与神经精神量表间的关系。结果与HC组相比,SLE组患者在胼胝体(膝部、体部、压部)、双侧前、上放射冠、丘脑后辐射、外囊、上纵束及右侧后放射冠FA值均明显降低(P均<0.05);在胼胝体(膝部、体部、压部)、内囊膝支、双侧前、上、后放射冠、丘脑后辐射、上纵束及左侧外囊MD值均明显升高(P均<0.05),在胼胝体(膝部、体部、压部)、内囊后肢、双侧前、上放射冠、双侧丘脑后辐射、外囊、上纵束及右侧后放射冠MK值均明显降低(P均<0.05)。相关性分析发现,简易精神状态量表(MMSE)评分与胼胝体体部的FA、MK值呈正相关(r=0.5487,P<0.05;r=0.4269,P<0.05),与胼胝体体部的MD值呈负相关(r=-0.5487,P<0.05)。结论DKI技术能够发现SLE患者白质结构的改变,且差异脑区白质结构的改变与神经精神量表具有一定相关性。Objective To investigate the alteration of white matter structure in patients with systemic lupus erythemato-sus(SLE)and its correlation with neuropsychiatric scale by diffuse peak imaging(DKI).Methods A total of 41 female patients with SLE(SLE group)and 45 healthy volunteers(HCs)matching their age,sex and education level were selected for DKI examination,and the differences between fractionalanisotropy(FA),mean diffusion(MD)and mean kurtosis(MK)of the statistically different brain regions were measured,and the relationship between the FA,MD and MK values of the different brain regions and the neuropsychiatric scale was investigated by spearman correlation analysis.Results Com-pared with the HC group,the FA values of the corpus callosum(knee,body,pressure),bilateral anterior,superior radiation crown,retrothalamus radiation,external capsule,superior longitudinal tract and right posterior radiation crown were signifi-cantly reduced in the SLE group(P average<O.05).The MD values of the callosum(knee,body,pressure),the medial capsule knee branch,the bilateral anterior,superior,and posterior radiation crown,the retrothalamus radiation,the superior longitudinal tract,and the left external capsule were significantly increased(P average<0.05),and in the callosum(knee,body,pressure),posterior limbs of the medial capsule,bilateral anterior,superior radiation crown,bilateral retrothala-mus radiation,external capsule,superior longitudinal tract,and right posterior radiation crown were significantly reduced(P average<0.05).Correlation analysis showed that the MMSE scale score was positively correlated with the FA and MK val-ues of the callosum body part(r=0.5487,P<0.05;r=0.4269,P<0.05),and was negatively correlated with the MD value of the callosum body part(r=-0.5487,P<0.05).Conclusion DKI technology can detectchanges in white matter structure in patients with SLE,and the changes in white matter structure in different brain regions have a certain correlation with the neuropsychiatric scale.

关 键 词：扩散峰度成像 系统性红斑狼疮 各向异性分数 平均扩散系数 平均扩散峰度 

分 类 号：R593.241[医药卫生—内科学]