基于扩散峰度成像的颞叶癫痫伴睡眠障碍患者大脑白质结构研究  

Abnormal changes of white matter structure in temporal lobe epilepsy patients with sleep disorders based on diffusion kurtosis imaging

作　　者：郭敏 李延静[2] 申博兴 罗虹 袁若涵 胡洁 唐兴 GUO Min;LI Yanjing;SHEN Boxing;LUO Hong;YUAN Ruohan;HU Jie;TANG Xing(Department of Radiology,Xijing Hospital,the Air Force Medical University,Xi'an 710032,China;Department of Radiology,Yan'an University Affiliated Hospital,Yan'an,Shaanci Province 716000,China)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032 [2]延安大学附属医院心脑血管病区放射科,陕西延安716000

出　　处：《实用放射学杂志》2024年第1期1-5,共5页Journal of Practical Radiology

基　　金：中国红十字基金会“影瑞西北公益行”之ICON科研基金项目(XM_HR_ICON_2020_10)。

摘　　要：目的探讨基于扩散峰度成像(DKI)的颞叶癫痫(TLE)合并睡眠障碍患者的脑白质微观结构改变。方法前瞻性纳入TLE患者(病例组)38例,健康对照(HC)(HC组)20例。向受试者发放睡眠调查问卷评估其睡眠状况,根据睡眠障碍的诊断标准和量表评分将TLE患者分为合并睡眠障碍组及未合并睡眠障碍组。采集所有受试者DKI序列并测量相关感兴趣区(ROI)的平均扩散峰度(MK)、平均扩散率(MD)和各向异性分数(FA)3个扩散参数。使用独立样本t检验、单因素方差分析比较睡眠质量评分、DKI参数的组间差异。结果TLE合并睡眠障碍组的Epworth嗜睡量表(ESS)、阿森斯失眠量表(AIS)评分及匹兹堡睡眠质量指数(PSQI)均高于HC组(P<0.05)。TLE患者较HC组的FA、MK值明显减低,MD值明显升高(P<0.05);左侧TLE患者合并睡眠障碍组的MK、FA值较未合并睡眠障碍组明显减低(P<0.05),未发现MD值存在组间差异(P>0.05);右侧TLE患者合并睡眠障碍组的MK值较未合并睡眠障碍组明显减低(P<0.05),未发现MD、FA值存在组间差异(P>0.05)。结论通过DKI定量分析发现TLE合并睡眠障碍患者存在DKI参数差异,推测该群体存在特异性大脑白质纤维损伤,进一步为该类患者的个性化治疗和预后评估提供一定的影像学数据支撑。Objective To investigate the microstructural changes of temporal lobe epilepsy(TLE)in patients with sleep disorders based on diffusion kurtosis imaging(DKI).Methods This research prospectively included 38 TLE patients(case group)and 20 healthy controls(HC)(HC group).Participants used sleep questionnaires to evaluate their sleep status.All TLE patients were divided into groups with and without sleep disorders according to the diagnostic criteria and scale scores of sleep disorders.The mean kurtosis(MK),mean diffusivity(MD),and fractional anisotropy(FA)of the relevant region of interest(ROI)were measured by DKI sequence.The differences of sleep quality scores and DKI parameters between groups were further compared via independent samples t-test and one-way analysis of variance.Results The Epworth sleepiness scale(ESS),Athens insomnia scale(AIS),and Pittsburgh sleep quality index(PSQI)scores of TLE patients with sleep disorders were significantly higher than those of HC group(P<0.05).The FA and MK values in TLE patients were significantly lower than those in HC group,while the MD value of TLE patients were substantially higher than that of HC group(P<0.05).The values of MK and FA in left TLE patients with sleep disorders were significantly lower than those of without sleep disorders(P<0.05),while there was no significant difference in MD value between the two groups(P>0.05).MK value of right TLE patients with sleep disorders was significantly lower than that of without sleep disorders(P<0.05),however,there were no significant differences in MD and FA values between the two groups(P>0.05).Conclusion Quantitative DKI analysis revealed differences in DKI parameters in TLE patients combined with sleep disorders,inferring a specific white matter fiber damage in this group and providing imaging data to support the personalized treatment and prognostic assessment of these patients.

关 键 词：扩散峰度成像 颞叶癫痫 睡眠障碍 睡眠量表 白质微观结构 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学] R338.63[医药卫生—临床医学]