基于扩散张量成像-阿尔卑斯指数的脑出血胶质淋巴系统功能评价  

Evaluation of glial lymphatic system function of cerebral hemorrhage based on diffusion tensor imaging analysis along the perivascular space index

作　　者：沙静云 蔡璐璐 赵厚亮 胡鹏程 徐凯 张超 SHA Jingyun;CAI Lulu;ZHAO Houliang;HU Pengcheng;XU Kai;ZHANG Chao(Department of Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province 221006,China;Xuzhou Medical University,Xuzhou,Jiangsu Province 221004,China)

机构地区：[1]徐州医科大学附属医院影像科,江苏徐州221006 [2]徐州医科大学,江苏徐州221004

出　　处：《实用放射学杂志》2024年第5期689-692,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目(82172005);江苏省老年健康科研课题(LKM2023014);江苏省卫生健康委员会科研项目(H2023134)。

摘　　要：目的利用MR扩散张量成像(DTI)探讨自发性脑出血(sICH)患者脑胶质淋巴系统功能的变化。方法回顾性收集符合sICH的32例患者(sICH组)和31例健康志愿者(对照组)的临床及影像学资料,采集所有被试的DTI不同方向扩散率值,计算扩散张量成像-阿尔卑斯(DTI-ALPS)指数,通过比较sICH组与对照组之间DTI-ALPS指数值的差异,评价sICH患者脑胶质淋巴系统功能的变化;并进一步分析sICH患者DTI-ALPS指数与临床指标的相关性。结果sICH组病灶侧大脑半球DTI-ALPS指数显著低于健侧(P<0.01,t=-5.03),同样显著低于对照组左侧(P<0.01,t=-9.85)和右侧(P<0.01,t=-8.80);此外,32例患者中有8例进行了血管内皮生长因子(VEGF)检测,其水平[(187.40±19.11)pg/mL]明显高于正常范围(0~142.20pg/mL)。结论DTI-ALPS指数的定量分析能够反映sICH脑胶质淋巴系统功能的损害,MRDTI技术能够从新的角度揭示sICH后大脑病理、生理变化。Objective To explore the functional changes of the glial lymphatic system in patients with spontaneous intracerebral hemorrhage(sICH)by MR diffusion tensor imaging(DTI).Methods The clinical and imaging data of 32 sICH patients(sICH group)and 31 healthy volunteers(control group)were retrospectively collected,and the diffusivity values of DTI in different direc-tions were collected from all the subjects,the diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)index was calculated,the difference of DTI-ALPS index values between the sICH group and the control group was compared,the changes in the function of the glial lymphatic system in sICH patients were evaluated,and the correlation between DTI-ALPS index and clinical indi-cators in sICH patients was further analyzed.Results The DTI-ALPS index of cerebral hemispheres on the lesions side of sICH group was significantly lower than that on the unaffected side(P<0.01,t=-5.03),and lower than that on the left side of control group(P<0.01,t=-9.85)and the right side(P<0.01,t=-8.80).In addition,vascular endothelial growth factor(VEGF)tes-ting was performed in 8 of the 32 patients,and the levels(187.40±19.11)pg/mLJwere significantly higher than the normal range(O-142.20 pg/mL).Conclusion Through the quantitative analysis of the DTI-ALPS index,the damage to the function of the glial lymphatic system of sICH can be reflected,and perhaps the mechanism of pathophysiological changes in the brain after sICH can be reflected froma new perspectivebyusing MRDTI technology.

关 键 词：自发性脑出血 脑胶质淋巴系统 扩散张量成像-阿尔卑斯指数 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]