NODDI技术对颞叶癫痫认知障碍患者海马微结构的临床研究  

Clinical study of hippocampal microstructure in patients with cognitive impairment of temporallobe epilepsy by NODDI technique

作　　者：杨文蕊 王旭聪 李健 宋邓妍 王卓 陈兵[1] YANG Wenrui;WANG Xucong;LI Jian;SONG Dengyan;WANG Zhuo;CHEN Bing(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;School of the First Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750004 [2]宁夏医科大学第一临床医学院,银川750004

出　　处：《磁共振成像》2024年第11期39-43,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区重点研发项目(编号:2020BEG03026);宁医大总院2022年新入职硕士人才培养项目(编号:[2023]394号)。

摘　　要：目的利用神经突方向离散度与密度成像(neurite orientation dispersion and density imaging,NODDI)探索颞叶癫痫认知障碍(cognitive impairment of temporal lobe epilepsy,TLE-CI)患者、颞叶癫痫认知正常(cognitive normal of temporal lobe epilepsy,TLE-CN)患者海马微观结构的变化,并探讨其与临床发病特征之间的关系。材料与方法分析35例TLE-CI、31例TLE-CN及40例健康对照(healthy controls,HC)的头颅MRI,采用MRtrix3对NODDI图像的不同指标图:各向同性水分子体积分数(free-water isotropic volume fraction,fiso)、方向离散度指数(orientation dispersion index,ODI)及神经突密度指数(neurite density index,NDI)进行计算。然后与经过FreeSurfer分割后的结构像叠加,得到海马区的NODDI各指标值。比较三组参与者组间的NODDI指标差异,并将差异指标与患者的临床发病特征进行相关性分析。结果TLE-CI组患侧与对侧海马fiso值显著高于HC组(P=0.004,P=0.017);ODI值在组间分析中未见显著性差异;TLE-CI组患侧海马NDI值显著低于HC组(P<0.001),同时,TLE-CN组患侧海马NDI值显著低于HC组(P=0.004)。TLE-CI组患侧海马的NDI值与发病年龄呈正相关(r=0.491,P=0.003),与病程呈负相关(r=-0.424,P=0.011)。结论该研究显示了NODDI技术检测颞叶癫痫患者海马微结构变化的能力,其中,NDI值可能是TLE-CI患者较为敏感且进行性的生物标记物。Objective:To explore the changes of hippocampal microstructure in patients with cognitive impairment of temporal lobe epilepsy(TLE-CI)and normal temporal lobe epilepsy(TLE-CN)by neurite orientation dispersion and density imagin(NODDI),and to explore the relationship between hippocampal microstructure and clinical features.Materials and Methods:The head MRI of 35 cases of TLE-CI,31 cases of TLE-CN and 40 cases of healthy controls(HC)were analyzed.MRtrix3 was used to calculate the fraction of the isotropic diffusion compartment(fiso),orientation dispersion index(ODI)and neurite density index(NDI)of NODDI images.Then superimposed with the structure image after FreeSurfer segmentation,the NODDI index values of the hippocampus were obtained.The differences of NODDI indexes among the three groups of participants were compared,and the correlation between the difference indexes and the clinical characteristics of patients was analyzed.Results:The fiso value of ipsilateral and contralateral hippocampus in TLE-CI group was significantly higher than that in HC group(P=0.004,P=0.017),but there was no significant difference in ODI value between groups.The NDI value of ipsilateral hippocampus in the TLE-CI group was significantly lower than that in the HC group(P<0.001),while the NDI value of the affected hippocampus in the TLE-CN group was significantly lower than that in the HC group(P=0.004).In TLE-CI group,the NDI value of ipsilateral hippocampus was positively correlated with the age of onset(r=0.491,P=0.003)and negatively correlated with the course of disease(r=−0.424,P=0.011).Conclusions:This study shows the ability of NODDI to detect the microstructural changes of hippocampus in patients with temporal lobe epilepsy.Among them,NDI may be a sensitive and progressive biomarker in patients with TLE-CI.

关 键 词：颞叶癫痫 认知障碍 磁共振成像 神经突方向离散度和密度成像 神经突密度指数 方向离散度指数 各向同性水分子体积分数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]