MRI检测重度抑郁障碍合并躯体症状大脑灰质的价值分析  

Value Analysis of MRI Detection in Patients with Major Depressive Disorder Combined with Somatic Symptoms

作　　者：杨胜 蒋烈夫 李新 YANG Sheng;JIANG Liefu;LI Xin(Department of Medical Imaging,Nanyang Fourth People’s Hospital,Nanyang,Henan 473000,China;Department of Medical Imaging,Nanyang Zhang Zhongjing Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第四人民医院医学影像科,河南南阳473000 [2]南阳张仲景医院医学影像科,河南南阳473000

出　　处：《生物医学工程学进展》2024年第3期191-196,共6页Progress in Biomedical Engineering

摘　　要：目的探讨磁共振成像(Magnetic Resonance Imaging,MRI)检测重度抑郁障碍(Major Depressive Disorder,MDD)合并躯体症状的临床价值。方法选取2022年12月至2023年9月本院收治的MDD合并躯体症状患者127例作为研究对象,按健康问卷躯体症状群量表(Patient Health Questionnaire-15,PHQ-15)评分分成不伴躯体症状组(简称A组,总分:PHQ-15≥10分)和伴躯体症状组(简称B组,总分:PHQ-15<5分),两组分别有46例、81例,同时选取67名健康体检者作为参照对象。使用3.0MRI扫描仪进行扫描。利用VBM8软件包进行磁共振数据预处理,对比大脑灰质的体积差异。结果3组的PHQ-15评分、HAMD-24评分对比差异显著(P<0.05)。其中B组PHQ-15评分与A组PHQ-15评分略有差异,但差异不显著(P>0.05)。抑郁症组与健康对照组间的VBM分析显示,A组、B组右颞下回脑区和左颞上回脑区的体积较对照组减小;A组、B组右颞中回、左距状裂所在脑区体积较对照组增大。其中B组右眶额下回体素数目显著低于A组(P<0.001)。B组右颞中回、左距状裂的体素数目较A组显著增大(P<0.05)。结论相较于不伴躯体症状的抑郁症患者,伴有躯体症状的抑郁症患者经MRI检测可发现更多大脑灰质结构的变化。这些大脑结构的异常可能是导致抑郁症患者出现各种躯体症状的神经基础。Objective To explore the clinical value of magnetic resonance imaging(MRI)in detecting major depressive disorder(MDD)associated with somatic symptoms.Methods 127 MDD patients with somatic symptoms admitted to our hospital from December 2022 to September 2023 were selected and divided into group without somatic symptoms(group A,PHQ-15≥10)and group with somatic symptoms(group B,PHQ-15<5)and the patients’number of group A and group B was 46 and 81 respectively.Meanwhile,67 healthy examination patients were selected as the reference objects.Select The 3.0MRI scanner were used for scanning.The MR data were preprocessed using VBM8 software package to compare the volume differences in cerebral gray matter.Results PHQ-15 scores and HAMD-24 scores varied significantly among the three groups(P<0.05).The PHQ-15 score of Group B was slightly different from the PHQ-15 score of Group A,but not significantly(P>0.05).VBM analysis between depression group and healthy control group showed that the volume of right inferior and left superior temporal gyrus in group A and group B decreased compared with the control group.The volume of the right middle temporal gyrus and left talar fissure in group A and group B increased compared with the control group.The number of voxels in the right inferior orbitofrontal gyrus in group B was significantly lower than that in group A(P<0.001).The number of voxels in right middle temporal gyrus and left talatus of group B with somatic symptoms increased significantly compared with group A(P<0.05).Conclusion Depression patients with somatic symptoms can find more changes in gray matter structure by MRI than those without somatic symptoms.These abnormalities in brain structures may be the neural basis for the development of various somatic symptoms in depressed patients.

关 键 词：MRI 重度抑郁障碍合并躯体症状 躯体症状 PHQ-15 

分 类 号：R749.4[医药卫生—神经病学与精神病学]