扩散峰度成像对遗尿症男童脑白质微结构改变的研究  

Research on the white matter microstructural changes in boys with enuresis using diffusion kurtosis imaging

作　　者：杨子剑 马骏[3] 杜小霞 林昕迪 陈群 王梦星 YANG Zijian;MA Jun;DU Xiaoxia;LIN Xindi;CHEN Qun;WANG Mengxing(School of Health Sciences and Engineering,University of Shanghai for Science and Technology,Shanghai 200093,China;School of Medical Imaging,Shanghai University of Medicine&Health Sciences,Shanghai 200237,China;Developmental and Behavioral Pediatrics,Shanghai Children's Medical Center Affiliated with Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;School of Psychology,Shanghai University of Sport,Shanghai 200003,China)

机构地区：[1]上海理工大学健康科学与工程学院,上海200093 [2]上海健康医学院医学影像学院,上海200237 [3]上海交通大学医学院附属上海儿童医学中心发育行为儿科,上海200127 [4]上海体育大学心理学院,上海200003

出　　处：《磁共振成像》2024年第11期44-50,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:81901720);上海市2020年度“科技创新行动计划”自然科学基金项目(编号:20ZR1434700)。

摘　　要：目的应用磁共振扩散峰度成像(diffusion kurtosis imaging,DKI)技术中基于纤维束的空间统计分析方法(tract-based spatial statistics,TBSS)探讨原发夜间遗尿症男童脑白质结构的改变及其与儿童行为量表(Child Behavior Checklist,CBCL)评分的相关性。材料与方法选取25例男性遗尿症(enuresis,NE)患者(NE组)及24名与其年龄、性别及受教育年限相匹配健康对照(healthy controls,HC)(HC组)进行磁共振DKI扫描,测定差异有统计学意义的脑区的平均扩散系数(mean diffusivity,MD)、平均扩散峰度(mean kurtosis,MK)、轴向峰度(axial kurtosis,AK),并采用Spearman相关性分析探讨差异脑区MD、AK及MK值与儿童行为表现间的关系。结果与HC组相比,NE组患者在丘脑前辐射右侧、双侧皮质脊髓束MK值明显升高(P<0.05);在下纵束右侧、皮质脊髓束左侧、下额枕束右侧、大钳AK值均明显升高(P<0.05);在双侧下纵束、双侧皮质脊髓束、丘脑前辐射右侧MD值明显降低(P<0.05)。相关性分析发现,CBCL评分与皮质脊髓束右侧、下纵束右侧的MK、MD值呈正相关,儿童睡眠习惯问卷(Children's Sleep Habits Questionnaire,CSHQ)评分与下纵束右侧、丘脑前辐射右侧、下纵束左侧的MD值呈正相关。结论DKI技术能够发现NE患者脑白质结构的改变,且差异脑区白质结构的改变与CBCL及CSHQ具有一定相关性。Objective:Using the tract-based spatial statistics(TBSS)method based on diffusion kurtosis imaging(DKI)technology to explore the changes in brain white matter structure of boys with primary nocturnal enuresis and its correlation with child behavior scales.Materials and Methods:MR DKI scans were conducted on 25 enuresis male patients with NE(NE group)and 24 age,gender,and education matched healthy control(HC group).The mean diffusivity(MD),mean kurtosis(MK),and axial kurtosis(AK)values of brain regions with statistical significance were determined,and Spearman correlation analysis was performed to explore the relationship between the MD,AK,and MK values in the different brain regions and children's behavioral performance.Results:Compared with the HC group,the NE group showed significantly increased MK values in the right preoptic tract,bilateral corticospinal tract(P<0.05);There is a significant increase in the AK value in the right lower longitudinal bundle,the left corticospinal tract,the right inferior fronto-occipital fasciculus,and the large claw(P<0.05);and a significant decrease in the MD value in the right anterior thalamic radiation,as well as in the bilateral lower longitudinal bundles,bilateral corticospinal tracts,and left anterior thalamic radiation(P<0.05).Correlation analysis revealed that the scores of the Children's Behavior Checklist(CBCL)were positively correlated with the MK and MD values of the right corticospinal tract and the right lower longitudinal bundle.The scores of the Children's Sleep Habits Questionnaire(CSHQ)were positively correlated with the MD values of the right lower longitudinal bundle,the right anterior thalamic radiation,and the left lower longitudinal bundle.Conclusions:DKI technology can detect white matter structure alterations in NE patients,and the changes in white matter structure in the different brain regions are associated with the CBCL and CSHQ.

关 键 词：遗尿症 磁共振扩散峰度成像技术 基于纤维束的空间统计分析方法 脑白质结构 儿童行为量表 

分 类 号：R445.2[医药卫生—影像医学与核医学] R694.53[医药卫生—诊断学]