磁共振弥散张量成像对系统性红斑狼疮患者脑小血管病的评估价值  

Evaluation value of magnetic resonance diffusion tensor imaging for cerebrovascular small vessel disease in patients with systemic lupus erythematosus

作　　者：吴恺迪 任占云[1] 史一雯 王文云 钱振宇 汤武装 Wu Kaidi;Ren Zhanyun;Shi Yiwen;Wang Wenyun;Qian Zhenyu;Tang Wuzhuang(Department of Neurology,Yixing People's Hospital,Yixing 214200,China)

机构地区：[1]宜兴市人民医院神经内科,宜兴214200

出　　处：《中国医师进修杂志》2024年第2期97-102,共6页Chinese Journal of Postgraduates of Medicine

基　　金：无锡市卫生健康委员会科研项目(M202143)。

摘　　要：目的探讨磁共振弥散张量成像(DTI)对系统性红斑狼疮(SLE)患者脑小血管病(CSVD)的评估价值。方法采用前瞻性研究的方法,选择宜兴市人民医院2022年1—12月治疗的SLE合并CSVD患者82例,根据常规MRI检查结果分为急性期梗死组(16例)、慢性期梗死组(26例)和慢性缺血灶组(40例),所有患者均行DTI检查,获取患侧及对侧正常脑白质区的平均弥散系数(DCavg)和各向异性分数(FA),分析DTI对SLE患者CSVD的评估价值。结果82例患者病灶患侧DCavg显著高于健侧[(11.10±3.48)10^(-3)mm^(2)/s比(8.18±2.42)10^(-3)mm^(2)/s],患侧FA显著低于健侧(0.28±0.05比0.45±0.08),差异有统计学意义(P<0.05)。急性梗死期组、慢性期梗死组、慢性缺血灶组DCavg分别为(11.88±3.50)、(9.69±3.24)和(8.52±2.34)10^(-3)mm^(2)/s,差异有统计学意义(P<0.05);急性梗死期组、慢性期梗死组、慢性缺血灶组FA分别为0.28±0.04、0.33±0.06和0.40±0.07,差异有统计学意义(P<0.05)。绘制受试者工作特征曲线,结果显示,DCavg、FA单独及联合评估急性期梗死组和慢性期梗死组的曲线下面积(AUC)分别为0.757、0.756和0.820,评估慢性期梗死组和慢性缺血灶组的AUC分别为0.772、0.776和0.813,联合评估的AUC值相对较大。结论DTI对SLE患者CSVD具有良好的评估价值,可准确判断CSVD类型。Objective To explore the value of magnetic resonance diffusion tensor imaging(DTI)in evaluating cerebrovascular small vessel disease(CSVD)in patients with systemic lupus erythematosus(SLE).Methods Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected.They were divided into acute phase infarction group(16 cases),chronic phase infarction group(26 cases),and chronic ischemic lesion group(40 cases)based on routine MRI examination results.All patients underwent DTI examination to obtain the average diffusion coefficient(DCavg)and anisotropy score(FA)of the affected and contralateral normal white matter areas,and the evaluation value of DTI for CSVD in SLE patients was analyzed.Results The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side:(11.10±3.48)10^(-3)mm^(2)/s vs.(8.18±2.42)10^(-3)mm^(2)/s,and the FA value on the affected side was significantly lower than that on the healthy side:0.28±0.05 vs.0.45±0.08,with a statistical significant differences(P<0.05).The DCavg values of the acute infarction group,chronic infarction group,and chronic ischemic focus group were(11.88±3.50),(9.69±3.24)and(8.52±2.34)10^(-3)mm^(2)/s,respectively,with statistical significant differences(P<0.05).The FA values of the acute infarction group,chronic infarction group,and chronic ischemic focus group were 0.28±0.04,0.33±0.06 and 0.40±0.07,respectively,with statistical significant differences(P<0.05).The receiver operating characteristic curve was drawn,and the results showed that the area under the curve(AUC)of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757,0.756,and 0.820,respectively.The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772,0.776,and 0.813,respectively.The AUC value of the combined evaluation was relatively large.Conclusions DTI has good eva

关 键 词：红斑狼疮 系统性 脑小血管病 磁共振成像 弥散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.241[医药卫生—诊断学] R743[医药卫生—临床医学]