MRI定量评估脊髓小脑共济失调3型患者类淋巴系统与运动障碍的关联研究  

Quantitative MRI research on the correlation between the glymphatic system and motor dysfunction in spinocerebellar ataxia type 3

作　　者：欧沛灵 甄志铭 黄永华 邓利华 石琳锋 吴交交 花蕊 石峰 王健 刘晨 Ou Peiling;Zhen Zhiming;Huang Yonghua;Deng Lihua;Shi Linfeng;Wu Jiaojiao;Hua Rui;Shi Feng;Wang Jian;Liu Chen(7T Magnetic Resonance Translational Medicine Research Center,Department of Radiology,Southwest Hospital,Army Medical University(Third Military Medical University),Chongqing 400000,China;Department of Research and Development,Shanghai United Imaging Intelligence Institute,Shanghai 200232,China)

机构地区：[1]陆军军医大学第一附属医院7T磁共振转化医学研究中心/放射科,重庆400000 [2]上海联影智能研究院,上海200232

出　　处：《中华放射学杂志》2024年第12期1396-1401,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金(82071910,81601478);重庆市中青年高端医学人才(414Z395);陆军军医大学第一附属医院优青拔尖基金(2024YQBJ-2)。

摘　　要：目的基于MRI定量分析脊髓小脑共济失调3型(SCA3)患者的类淋巴系统变化及其与CAG重复数和运动障碍之间的关系。方法该研究为横断面研究。前瞻性收集2017年5月至2023年6月在陆军军医大学第一附属医院接受诊治的SCA3患者39例(SCA3组)及人口统计学匹配的健康对照组40名(HC组)。所有被试者均接受头颅MRI扫描,并评估其共济失调等级量表(SARA)和国际合作共济失调评分表(ICARS)评分。基于Freesurfer软件对脉络丛进行自动分割及体积测量;基于深度学习模型VB-Net自动分割血管周围间隙(PVS),经人工矫正后定量统计各脑区的PVS体积。采用独立样本t检验和Mann-Whitney U检验分析SCA3组与HC组类淋巴系统的变化;采用Pearson偏相关性分析探究CAG重复次数、类淋巴系统及运动障碍之间的关系。结果SCA3组的标准化脉络丛体积为(1.24±0.36)×10^(3) mm^(3),HC组的标准化脉络丛体积为(0.96±0.34)×10^(3) mm^(3),差异有统计学意义(t=4.01,P<0.001)。SCA3组在额叶、颞叶、顶叶、基底节、小脑、丘脑及脑干区域的PVS体积显著高于HC组(P<0.05)。偏相关分析结果显示,SAC3患者的CAG重复数与SARA评分、ICARS评分、基底节PVS体积呈正相关(r分别为0.65、0.58、0.29,P分别为0.001、0.001、0.042);小脑、颞叶PVS体积与SARA评分呈正相关(r分别为0.59、0.47,P分别为0.001、0.003)、与ICARS评分呈正相关(r分别为0.61、0.40,P分别为0.001、0.011);脉络丛体积与小脑、基底节PVS体积呈正相关(r分别为0.41、0.31,P分别为0.009、0.043)。结论SCA3患者类淋巴系统存在显著改变,并且与CAG重复次数与运动障碍程度密切相关。Objective To investigate alterations in the glymphatic system of spinocerebellar ataxia type 3(SCA3)patients based on quantitative MRI,and its association with genetic information and motor dysfunction.Methods The study was a cross-sectional study.This prospective study recruited 39 confirmed SCA3 patients(SCA3 group)and 40 matched healthy controls(HC group)who were seen at the Southwest Hospital of Army Medical University from May 2017 to June 2023.All subjects underwent cranial MRI scanning.Clinical assessments were conducted on all participants using the scale for the assessment and rating of ataxia(SARA)and the international cooperative ataxia rating scale(ICARS).The automatic segmentation and volume measurement of the choroid plexus based on Freesurfer 6.0;the perivascular interstitial space(PVS)was automatically segmented based on the deep-learning model VB-Net,and the volume of the PVS in each brain region was quantified after manual correction.Independent samples t-test and Mann-Whitney U-test were used to analyze the changes in the class lymphatic system in the SCA3 group and the HC group.Pearson partial correlation analysis was used to explore the relationship between CAG repeats,the glymphatic system,and motor dysfunction.Results The standardized choroid plexus volume in the SCA3 group was(1.24±0.36)×10^(3) mm^(3),and that in the HC group was(0.96±0.34)×10^(3) mm^(3),with a statistically significant difference(t=4.01,P<0.001).PVS volumes in the frontal lobe,temporal lobe,parietal lobe,basal ganglia,cerebellum,thalamus,and brainstem regions in the SCA3 group were significantly higher than those of HC group(P<0.05).Partial correlation analysis revealed that CAG repeats in SCA3 group were positively correlated with SARA,ICARS,and basal ganglia PVS volumes(r=0.65,0.58,0.29;P=0.001,0.001,0.042).Cerebellar and temporal lobe PVS volumes were positively correlated with SARA(r=0.59,0.47;P=0.001,0.003),and positively correlated with ICARS scores(r=0.61,0.40;P=0.001,0.011).Choroid plexus volume was positively

关 键 词：脊髓小脑共济失调 类淋巴系统 磁共振成像 运动障碍 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.7[医药卫生—诊断学]