磁共振酰胺质子转移成像评估稳定期慢性阻塞性肺疾病患者中枢神经系统损伤  

Central Nervous System Injury in Stable Chronic Obstructive Pulmonary Disease Patients by Using Magnetic Resonance Amide Proton Transfer Imaging

作　　者：张刚[1] 贺俊景 孙杰梅 周丽格 邢威[1] ZHANG Gang;HE Junjing;SUN Jiemei;ZHOU Lige;XING Wei(Department of Magnetic Resonance Room,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院磁共振室,河南郑州450000

出　　处：《中国医学影像学杂志》2024年第11期1105-1110,1117,共7页Chinese Journal of Medical Imaging

基　　金：河南省科技公关项目(232102310123)。

摘　　要：目的 应用3D酰胺质子转移加权(APTw)成像技术评估稳定期慢性阻塞性肺疾病(COPD)患者中枢神经系统损伤的可行性及应用价值。资料与方法 前瞻性选取2022年1月—2023年8月在河南中医药大学第一附属医院就诊的36例COPD患者与31名年龄、性别相匹配的健康志愿者。所有受试者均接受肺功能测试、血常规检查、蒙特利尔认知评估量表(Mo CA)评估及3.0T MRI扫描。由2名观察者独立测量各脑区的APT值并评估其一致性,比较两组间各脑区的APT值差异,探讨多脑区APT值与肺功能、血液指标及Mo CA评分的相关性。结果 观察者间对多脑区APT值的测量一致性良好(组内相关系数>0.75);COPD组脑区APT值高于健康对照组,双侧苍白球(t=2.490、2.168)、右侧丘脑(t=2.754)、壳核(t=2.137)、颞叶灰质(t=3.533)和枕叶灰质(t=2.345)较健康对照组差异有统计学意义(P均<0.05);多脑区APT值与Mo CA评分呈负相关(r=-0.390~-0.084),其中双侧苍白球的相关性较强(r=-0.390、-0.370,P<0.05);COPD组的肺功能指标(用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积/用力肺活量、第1秒用力呼气容积占预计值的百分比)与多脑区APT值呈负相关的趋势(r=-0.339~-0.010,P均>0.05),而白细胞计数、红细胞计数、血红蛋白浓度和血小板计数与多脑区APT值呈正相关的趋势(r=0.084~0.587)。结论 APTw作为一种新型的MRI技术,在检测COPD患者中枢神经系统损伤及非侵入性监测疾病进展方面有潜在应用价值。Purpose The feasibility and application value of 3D amide proton transfer weighted(APTw)imaging is used to evaluate central nervous system injury in stable chronic obstructive pulmonary disease(COPD)patients.Materials and Methods A total of 36 COPD patients who attended the First Affiliated Hospital of Henan University of Chinese Medicine from January 2022 to August 2023 were selected along with 31 age-and gender-matched healthy volunteers.All subjects underwent pulmonary function tests,routine blood tests,Montreal cognitive assessment scale(MoCA)assessment and 3.0T MRI scan.The APT values of each brain region were measured independently and assessed for consistency by two observers,and the differences in APT values of each brain region were compared between the two groups to explore the correlation between the APT values of multiple brain regions and the pulmonary function,blood indices,and MoCA scores.Results The measurement consistency of APT values in multiple brain regions among observers was good(ICC>0.75).The APT values of brain regions in the COPD group were higher than those in the healthy control group,with statistically significant differences between the bilateral pallidum(t=2.490,2.168),the right thalamus(t=2.754),the nucleus accumbens(t=2.137),the temporal lobe gray matter(t=3.533)and the occipital lobe gray matter(t=2.345)compared with those in the healthy control group(all P<0.05);the APT values of the multiple brain regions were in a negative correlation(r=-0.390--0.084),with a stronger correlation between bilateral pallidum(r=-0.390,-0.370,both P<0.05);lung function indexes(forced vital capacity,forced expiratory volume in one second,forced expiratory volume in one second/forced vital capacity,forced expiratory volume in one second/prediction)in the COPD group showed a negative correlation trend with the APT values of the multibulbar areas(r=-0.339--0.010,all P>0.05),while white blood cell count,red blood cell count,hemoglobin concentration and platelet count showed a positive correlation trend

关 键 词：肺疾病 慢性阻塞性 磁共振成像 酰胺质子转移加权成像 中枢神经系统 

分 类 号：R563.9[医药卫生—呼吸系统] R445.2[医药卫生—内科学]