基于DKI技术对遗忘型轻度认知障碍患者皮层微结构改变特征的研究  

The changes of cortical microstructure in amnestic mild cognitive impairment patients using diffusion kurtosis imaging

作　　者：牛晓茜 郭莹[1] 李彤彤 倪红艳[3] NIU Xiao-xi;GUO Ying;LI Tong-tong(The First Central Clinical School,Tianiin Medical University,Tianjin 300192,China)

机构地区：[1]天津医科大学一中心临床学院,天津300192 [2]河北大学附属医院放射科,河北071000 [3]天津市第一中心医院放射科,天津300192

出　　处：《放射学实践》2024年第9期1122-1129,共8页Radiologic Practice

基　　金：国家自然科学基金(编号:30870713);天津市自然科学基金项目(编号:21JCZDJC01210);天津市卫生健康科技项目(编号:ZD20003,ZC20011)资助。

摘　　要：目的:采用扩散峰度成像(DKI)技术研究遗忘型轻度认知障碍(aMCI)患者皮层微结构的改变特征。方法:前瞻性搜集47例aMCI患者和46例正常对照(NC)进行结构像和扩散序列功能像扫描,利用FreeSurfer软件基于皮层分析方法比较两组受试者灰质DKI参数的差异,包括平均扩散系数(MD)、径向扩散系数(RD)、轴向扩散系数(Ad)、各向异性分数(FA)、峰度各向异性(KFA)、平均峰度系数(MK)、径向峰度系数(RK)和轴向峰度系数(AK)。采用Spearman方法对DKI参数与简易智能状态检查量表(MMSE)评分进行相关性分析,利用受试者操作特征(ROC)曲线评估各参数值对aMCI的诊断效能。结果:与NC组相比,aMCI组多脑区的MD、RD、Ad值显著上升(P<0.05);FA、KFA、RK、MK值显著下降(P<0.05);NC组与aMCI组的AK值差异无统计学意义(P>0.05)。左侧岛回的MD值(r=-0.510,P<0.001)、左侧岛回的Ad值(r=-0.494,P<0.001)、左侧颞下回的RD值(r=-0.539,P<0.001)与MMSE评分呈负相关;左侧额中回上部的KFA值(r=0.480,P<0.001)与MMSE评分呈正相关。右侧中央前回的KFA值诊断aMCI的AUC最大(AUC=0.794)。结论:aMCI患者存在皮层微结构完整性的破坏,基于皮层分析DKI参数的改变反映了aMCI患者皮层微结构的受损特征。KFA值对aMCI具有最佳诊断效能,可能成为新型影像标志物。Objective:To investigate the changes of cortical microstructure in amnestic mild cognitive impairment(aMCI)patients by using diffusion kurtosis imaging(DKI).Methods:Forty seven aMCI patients and 46 normal controls were prospectively enrolled for structural imaging and functional imaging with diffusion sequence.We investigated the differences of DKI parameters in cortex between groups using surface-based analyses in Freesurfer software,including mean diffusivity(MD),radial diffusivity(RD),axial diffusivity(Ad),fractional anisotropy(FA),kurtosis fractional anisotropy(KFA),mean kurtosis(MK),radial kurtosis(RK)and axial kurtosis(AK).The correlation between DKI parameters and the mini mental state examination(MMSE)scores was assessed using Spearman coefficients.The diagnostic performance of different parameters on aMCI was evaluated using a receiver operating characteristic(ROC)curve.Results:Compared with the NC group,the MD,RD and Ad values of multiple regions increased in aMCI group(P<0.05),the FA、KFA、RK and MK values of multiple regions decreased in aMCI group(P<0.05).There was no significant difference in AK values between NC group and aMCI group(P>0.05).The MD value of left insula(r=-0.510,P<0.001),the Ad value of left insula(r=-0.494,P<0.001)and the RD value of left inferior temporal(r=-0.539,P<0.001)was negatively correlated with MMSE scores,respectively.The KFA value of left middle frontal(r=0.480,P<0.001)was positively correlated with MMSE scores.In addition,the KFA value of right precentral performed best for diagnosing aMCI(AUC=0.794).Conclusion:The integrity of cortical microstructures was damaged in aMCI patients.The changes of DKI parameters using surface-based analyses reflected the damaged characteristics of cortical microstructures in aMCI patients.The KFA values have the best diagnostic efficiency for distinguishing the aMCI from the NC,suggesting that it is promising as novel neuroimaging biomarkers.

关 键 词：遗忘型轻度认知障碍 扩散峰度成像 磁共振成像 皮层微结构 扩散系数 峰度系数 

分 类 号：R741.04[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]