基于TBSS方法对急性轻度创伤性脑损伤患者脑白质改变的扩散峰度成像研究  

Diffusion kurtosis imaging of brain white matter alteration in patients with acute mild traumatic brain injury based on the TBSS method

作　　者：郭冉 信瑞强[1] 石逸杰[1] 钟佳利[1] 杨宏宇 彭如臣[1] GUO Ran;XIN Ruiqiang;SHI Yijie;ZHONG Jiali;YANG Hongyu;PENG Ruchen(Department of Radiology,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院放射科,北京101149

出　　处：《磁共振成像》2024年第7期94-98,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：2021年度北京市重大疫情防治重点专科培育类项目(编号:京卫医[2021]135号);北京市通州区科技计划项目(编号:KJ2018CX009-05)。

摘　　要：目的 采用扩散峰度成像(diffusion kurtosis imaging, DKI)研究急性轻度创伤性脑损伤(mild traumatic brain injury,mTBI)患者脑白质微结构的变化特点,探讨DKI在mTBI患者的临床应用价值。材料与方法 分析2018年1月至12月于我院就诊的27例mTBI患者和性别、年龄、受教育年限相匹配的27例健康志愿者的临床及DKI影像数据,采用基于纤维束示踪的空间统计分析(tract-based spatial statistics, TBSS)方法分析mTBI组和对照组存在差异的脑区及其各向异性分数(fractional anisotropy, FA)值、平均峰度(mean kurtosis, MK)值、轴向峰度(axial kurtosis, AK)值、径向峰度(radial kurtosis, RK)值、峰度各向异性(kurtosis fractional anisotropy, KFA)值。结果 mTBI组左侧上纵束-颞叶部FA值(0.450±0.048)低于对照组(0.480±0.028,t=-2.253,P=0.028 5);mTBI组胼胝体辐射线枕部AK值(0.68±0.05)低于对照组(0.72±0.05,t=-2.407,P=0.019 7);mTBI组右侧扣带束海马部RK值(0.89±0.15)低于对照组(0.99±0.18,t=-2.044,P=0.046 0);mTBI组右侧丘脑前辐射、右侧扣带束的扣带皮层部、右侧下额枕束、右侧下纵束、右侧上纵束-颞叶部KFA值[(0.49±0.19)、(0.50±0.32)、(0.48±0.30)、(0.49±0.03)、(0.54±0.59)]均低于对照组[(0.51±0.13)、(0.52±0.20)、(0.50±0.02)、(0.51±0.26)、(0.57±0.46), t=-2.15、-2.95、-2.37、-2.38、-2.25,P均<0.05];mTBI组MK值与对照组相比差异无统计学意义(P>0.05)。结论 DKI参数可作为评估急性mTBI患者脑白质改变的神经影像生物标志物,可揭示脑白质微结构的微小变化。Objective:Diffusion kurtosis imaging(DKI)was used to study the white matter microstructure changes in mild traumatic brain injury(mTBI)patients,so as to explore the clinical application value of DKI in mTBI patients.Materials and Methods:The clinical and DKI data of 27 mTBI patients who were diagnosed in our hospital and 27 healthy control subjects matched in gender,age,and years of education recruited from January to December 2018 were analyzed.Using the tract-based spatial statistics(TBSS)method to analyze the differences in brain regions and their fractional anisotropy(FA)value,mean kurtosis(MK)value,axial kurtosis(AK)value,radial kurtosis(RK)value,and kurtosis fractional anisotropy(KFA)value between the mTBI patients subjects and the control subjects.Results:The FA value of the left superior longitudinal fasciculus(temporal part)was lower in mTBI patients(0.450±0.048)than that in the control subjects(0.480±0.028,t=-2.253,P=0.0285).The AK value of the forceps major was lower in mTBI patients(0.68±0.05)than that in the control subjects(0.72±0.05,t=-2.407,P=0.0197).The RK value of the right cingulum(hippocampus)was lower in mTBI patients(0.89±0.15)than that in the control subjects(0.99±0.18,t=-2.044,P=0.0460).The KFA values of the right anterior thalamic radiation,the right cingulum(cingulate gyrus),the right inferior fronto-occipital fasciculus,the right inferior longitudinal fasciculus,and the right superior longitudinal fasciculus(temporal part)were lower in mTBI patients[(0.49±0.19),(0.50±0.32),(0.48±0.30),(0.49±0.03),and(0.54±0.59)]than that in the control subjects[(0.51±0.13),(0.52±0.20),(0.50±0.02),(0.51±0.26),and(0.57±0.46),t=-2.15,-2.95,-2.37,-2.38,and-2.25,respectively,all P<0.05].However,there was no statistically significant difference in MK values between the subjectss(P>0.05).Conclusions:The DKI parameter serves as a neuroimaging biomarker for assessing brain white matter alterations in patients with acute mTBI,capable of unveiling minute variations in white matter microstructure.

关 键 词：创伤性脑损伤 磁共振成像 扩散峰度成像 基于纤维束示踪的空间统计分析 峰度各向异性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.1[医药卫生—诊断学]