基于伪连续式动脉自旋标记对原发性三叉神经痛病人疼痛相关脑区血流量的分析  

Cerebral blood flow analysis of pain-related brain regions in patients with primary trigeminal neuralgia using pseudo continuous arterial spin labeling

作　　者：程乾胜 韩彤[2] 曹宸 韩碧辉 程悦[3] 倪红艳[3] CHENG Qiansheng;HAN Tong;CAO Chen;HAN Bihui;CHENG Yue;NI Hongyan(Clinical College of The First Center of Tianjin Medical University,Tianjin 300192,China;Department of Radiology,Tianjin Huanhu Hospital;Department of Radiology,Tianjin First Central Hospital,Tianjin Institute of Imaging Medicine)

机构地区：[1]天津医科大学一中心临床学院,天津300192 [2]天津市环湖医院医学影像科 [3]天津市第一中心医院放射科天津市影像医学研究所

出　　处：《国际医学放射学杂志》2024年第1期7-11,59,共6页International Journal of Medical Radiology

基　　金：天津市科技计划项目(21JCZDJC01210,21JCYBJC01290);天津市自然科学基金(21JCYBJC01290);天津市卫生健康科技重点学科专项(TJWJ2023XK012)。

摘　　要：目的应用伪连续式动脉自旋标记(pCASL)技术分析原发性三叉神经痛(PTN)病人疼痛相关脑区局部脑血流量(rCBF)的变化。方法回顾性纳入48例PTN病人,根据疼痛部位将病人分为右侧PTN(RPTN)组28例和左侧PTN(LPTN)组20例,另纳入健康对照(HC)35例。全部研究对象均行常规头颅MRI及动脉自旋标记(ASL)成像检查,选取中央后回、岛叶、前扣带回、眶额皮质、丘脑共5个疼痛相关的感兴趣脑区(ROI)并分析rCBF值。采用配对t检验比较3组内左右两侧的rCBF值,采用SNK校正的单因素方差分析比较3组间的rCBF值。结果RPTN组左侧和LPTN组右侧的中央后回、眶额皮质r CBF均增高(均P<0.05),RPTN组和LPTN组右侧岛叶rCBF均增高(均P<0.05),RPTN组左侧和LPTN组右侧丘脑r CBF均减低(均P<0.05)。3组间比较发现,RPTN组左侧和LPTN组右侧的中央后回、眶额皮质r CBF值均高于其他2组(均P<0.05),RPTN组左侧和LPTN组右侧的丘脑rCBF值均低于其他2组(均P<0.05),RPTN组、LPTN组右侧岛叶rCBF值均高于HC组(均P<0.05)。结论pCASL技术显示PTN病人中央后回、右侧岛叶、眶额皮质、丘脑的rCBF均发生改变,提示PTN的发生可能导致与疼痛相关脑区的脑血流量的改变。Objective To analyze the changes of regional cerebral blood flow(rCBF)in pain-related brain regions of patients with primary trigeminal neuralgia(PTN)by pseudo continuous arterial spin labeling(pCASL)technique.Methods Forty-eight patients with PTN were retrospectively analyzed and divided into right PTN(RPTN)group(28 cases)and left PTN(LPTN)group(20 cases)according to the pain site,and 35 healthy control group(HC)cases were included.All subjects underwent conventional head MRI and arterial spin labeling(ASL)examination.Five pain-related brain regions of interest(ROI)including posterior central gyrus,insula,anterior cingulate gyrus,orbitofrontal cortex,and thalamus were selected for rCBF values analysis.Paired t test was used to compare rCBF values of left and right sides of the three groups,SNK corrected one-way ANOVA analysis was used to compare rCBF values among the three groups.Results The rCBF increased in both the left posterior central gyrus and orbitofrontal cortex of the RPTN group,and similarly in the right posterior central gyrus and orbitofrontal cortex of the LPTN group(both P<0.05).Additionally,both the RPTN and LPTN groups exhibited an increase in rCBF in the right insular(both P<0.05).Conversely,the rCBF decreased in both the left thalamus of the RPTN group and the right thalamus of the LPTN group(both P<0.05).Comparisons among the three groups revealed that the rCBF values of the left posterior central gyrus and orbitofrontal cortex in the RPTN group,as well as the right posterior central gyrus and orbitofrontal cortex in the LPTN group,were higher than those in the other two groups(both P<0.05).Furthermore,the rCBF values of the left thalamus in the RPTN group and the right thalamus in the LPTN group were lower than those of the other two groups(both P<0.05).Additionally,the rCBF values of the right insula in both RPTN and LPTN groups were higher than those in the HC group(both P<0.05).Conclusion Using pCASL technology,alterations in the rCBF of the postcentral gyrus,right insula,orbitofrontal co

关 键 词：三叉神经痛 磁共振成像 伪连续式动脉自旋标记 疼痛相关脑区 局部脑血流量 

分 类 号：R445.2[医药卫生—影像医学与核医学]