弥散张量成像在垂体大腺瘤患者脑白质改变中的研究  

Diffusion Tensor Imaging in the White Matter Changes of Patients with Pituitary Macroadenoma

作　　者：王好玉 何茜 赵波[1] 和仕珍 刘晨[1] 王鹏[1] WANG Haoyu;HE Qian;ZHAO Bo;HE Shizhen;LIU Chen;WANG Peng(Dept.of Radiology,Affiliated Hospital of Yunnan University/The 2nd People's Hospital of Yunnan Province/Eye Hospital of Yunnan Province,Kunming Yunnan 650021,China)

机构地区：[1]云南大学附属医院/云南省第二人民医院/云南省眼科医院放射科,云南昆明650021

出　　处：《昆明医科大学学报》2023年第12期72-78,共7页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(202001AY070001-088);高层次科技人才及创新团队选拔专项基金资助项目(202305AS350021)。

摘　　要：目的 利用磁共振弥散张量成像(diffusion tensor imaging,DTI)研究垂体腺瘤患者前视路结构受压后全脑白质纤维束微观结构的变化及其意义。方法 前瞻性纳入25例伴有视觉功能损伤的垂体腺瘤患者为研究组及相匹配的25例健康志愿者为对照组,2组受试者均进行临床数据及MRI数据采集,获得DTI数据及视功能评价指标。采用基于纤维束的空间统计(tract-based spatial statistics,TBSS)分析2组间脑白质各向异性分数(fractional anisotropy,FA)的差异,并分析其与视功能评价指标的相关性。结果 研究组双侧视放射及下额枕束的FA值较对照组降低(P <0.05)。相关性研究显示研究组左侧视放射及下额枕束的FA值与平均缺损、加权视野指数呈正相关(P <0.05),与模式偏差缺损呈负相关(P <0.05);研究组双侧视放射及下额枕束的FA值与嗅球-脑球高度呈负相关(P <0.05)。结论 垂体腺瘤患者前视路结构受压后双侧视放射及下额枕束发生了损伤,可能影响了患者的视功能,进一步说明DTI可以定量评估垂体腺瘤患者视路微观结构的损伤。Objective To investigate the microstructural changes in white matter of pituitary adenoma patients when the anterior visual pathway is compressed using diffusion tensor imaging(DTI)and discuss the clinical significance of these changes.Methods Clinical and MRI data of 25 patients with pituitary adenomas and 25 matched healthy controls were prospectively included.Tract-based spatial statistics(TBSS)was carried out to investigate difference in white matter integrity between 2 groups,which was measured using fractional anisotropy(FA).A correlation between visual function evaluation index and regional FA value was examined using correlation analysis.Results The FA values of bilateral optic radiations and inferior fronto-occipital fasciculus were significantly lower in the research group.The FA values of left optic radiation and inferior fronto-occipital fasciculus were positively correlated to mean deviation and visual field index,negatively correlated to patten standard deviation.The FA values of bilateral optic radiations and inferior fronto-occipital fasciculus were negatively correlated with Bulbo-pontine height.Conclusion Patients with pituitary adenoma may experience damage to the bilateral optic radiation and inferior fronto-occipital fasciculus after compression of the anterior visual pathway,which may affect the patient’s visual function,further indicating that DTI can quantitatively assess the microstructure damage of the visual pathway in patients with pituitary adenoma.

关 键 词：垂体腺瘤 弥散张量成像 视觉通路 脑白质 基于纤维束的空间统计 

分 类 号：R445.2[医药卫生—影像医学与核医学]