合成MRI观察中重度阻塞性睡眠呼吸暂停低通气综合征患者脑白质微结构改变  

Observing the Changes of White Matter Microstructure in Moderate and Severe Obstructive Sleep Apnea-Hypopnea Syndrome via Synthetic MRI

作　　者：刘青 彭琨[2] 汪凯宇 张宁 肖爱莲[4] LIU Qing;PENG Kun;WANG Kaiyu;ZHANG Ning;XIAO Ailian(Department of MRI,General Hospital of Taiyuan Iron&Steel(Group)Co.,LTD,Taiyuan 030008,China)

机构地区：[1]山西医科大学医学影像学院,山西太原030001 [2]太原钢铁(集团)有限公司总医院核磁共振室,山西太原030008 [3]GE医疗磁共振科研中心(中国),北京100000 [4]太原钢铁(集团)有限公司总医院呼吸与危重症医学科,山西太原030008

出　　处：《中国医学影像学杂志》2024年第10期988-993,共6页Chinese Journal of Medical Imaging

摘　　要：目的应用合成MRI研究中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者脑白质微观结构的变化情况。资料与方法前瞻性收集太原钢铁(集团)有限公司总医院2022年10月—2023年9月首次确诊的30例中重度OSAHS患者及30名健康对照者,受试者均行常规MRI、3D-T1 MPRAGE和合成MRI扫描,比较两组多个脑白质区域的T1、T2及质子密度(PD)值,并分析两组间有显著差异脑区的T1、T2及PD值与睡眠参数的相关性。结果与对照组相比,中重度OSAHS患者右侧大脑脚、扣带束、丘脑后辐射、外囊,双侧内囊、放射冠、上纵束、上额枕束T1值升高(t/Z=-3.267~3.286,P均<0.05),左侧小脑下脚T2值降低(Z=2.114,P=0.035),右侧丘脑后辐射、双侧外囊T2值升高(Z=-2.410、-2.484、-2.306,P均<0.05),胼胝体、左侧内囊、矢状层、海马,右侧丘脑后辐射、扣带束,双侧放射冠、上纵束PD值升高(t/Z=-3.726~2.757,P<0.05)。中重度OSAHS患者的呼吸暂停低通气指数与右侧扣带束T1值(r=0.387,P=0.035)、PD值(r=0.382,P=0.037)呈正相关,最低血氧饱和度与各定量参数值无相关性(P>0.05)。结论合成MRI可敏感地观察到中重度OSAHS患者脑白质弛豫值的变化,对评估OSAHS患者脑白质受损情况具有较高应用价值。Purpose To study the changes of white matter microstructure in moderate and severe obstructive sleep apnea-hypopnea syndrome(OSAHS)via synthetic MRI.Materials and Methods A total of 30 patients with moderate and severe OSAHS diagnosed for the first time and 30 healthy controls were prospectively collected in General Hospital of Taiyuan Iron&Steel(Group)Co.,LTD from October 2022 to September 2023.Both groups underwent routine MRI,3D-T1 MPRAGE and synthetic MRI scans.The T1,T2 and proton density(PD)values of multiple white matter regions in the two groups were compared,and the correlation between T1,T2 and PD values in different brain regions and sleep parameters was analyzed.Results Compared with the control group,the T1 value were increased in various white matter regions,including the right cerebral peduncle,cingulate fasciculus,posterior thalamic radiation,external capsule,bilateral internal capsule,corona radiata,superior longitudinal fasciculus and superior frontal-occipital fasciculus(t/Z=-3.267-3.286,all P<0.05).The T2 value of the left inferior cerebellar peduncle was decreased(Z=2.114,P=0.035),and the T2 value of the right posterior thalamic radiation and bilateral external capsule were increased(Z=-2.410,-2.484,-2.306,all P<0.05).Furthermore,the PD value were increased in corpus callosum,left internal capsule,sagittal layer,hippocampus,right posterior thalamic radiation,cingulate fasciculus,bilateral corona radiata and superior longitudinal fasciculus(t/Z=-3.726-2.757,all P<0.05).The apnea hypopnea index of patients with moderate and severe OSAHS was positively correlated with the T1 value(r=0.387,P=0.035)and PD value(r=0.382,P=0.037)of the right cingulate bundle,and there was no correlation between the lowest oxygen saturation and the quantitative parameters in moderate and severe OSAHS(P>0.05).Conclusion Synthetic MRI can sensitively observe the changes of white matter relaxation values in moderate and severe OSAHS,and has high application value in evaluating the damage of white matter in OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 白质 磁共振成像 

分 类 号：R563.8[医药卫生—呼吸系统] R445.2[医药卫生—内科学]