阻塞性睡眠呼吸暂停患者脑结构及功能磁共振成像研究进展  

The progress of brain structural and functional magnetic resonance imaging in patients withobstructive sleep apnea

作　　者：孙利强 李琳 胡婧 刘丽莹 崔凯歌 杨冀萍[3] 贾娟[3] 于佳琪 SUN Liqiang;LI Lin;HU Jing;LIU Liying;CUI Kaige;YANG Jiping;JIA Juan;YU Jiaqi(Department of Medical Imaging,Hebei General Hospital,Shijiazhuang 050051,China;Department of Otolaryngology,Hebei General Hospital,Shijiazhuang 050051,China;Department of Medical Imaging,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院医学影像科,石家庄050051 [2]河北省人民医院耳鼻咽喉科,石家庄050051 [3]河北医科大学第二医院医学影像科,石家庄050000

出　　处：《磁共振成像》2024年第11期160-168,共9页Chinese Journal of Magnetic Resonance Imaging

基　　金：河北省重点研发计划项目(编号:21377784D);河北省卫生健康委员会医学科学研究重点课题计划项目(编号:20160123、20150681);河北省2023年政府资助临床医学优秀人才培养项目(编号:ZF2023149)。

摘　　要：阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)是一种最常见的睡眠障碍性疾病,可引起脑结构和功能异常,进而导致认知障碍。近些年来,磁共振成像技术的发展日新月异,包括基于体素的形态测量学(voxel based morphometry,VBM)、扩散张量成像(diffusion tensor imaging,DTI)、沿血管周围间隙扩散张量成像分析(diffusion tensor imaging analysis along the perivascular space,DTI-ALPS)、扩散峰度成像(diffusion kurtosis imaging,DKI)、静息态功能磁共振成像(resting state functional MRI,rs-fMRI)、动脉自旋标记(arterial spin labeling,ASL)、磁共振波谱(magnetic resonance spectroscopy,MRS)等,为OSA患者脑微观结构改变及功能连接异常提供了良好的神经生物影像学标志。特别是DTI-ALPS和DKI等近年来新出现的磁共振成像技术,为OSA研究提供了更加新颖的角度和更为开阔的视野。DTI-ALPS可以无创性评估大脑类淋巴系统功能,揭示OSA患者大脑淋巴代谢障碍机制,为OSA患者病理生理学基础研究提供新的视角,甚至为治疗方案的完善提供新的观点。DKI能够在常规影像出现变化之前更为敏感地显示大脑微观结构异常,为OSA患者的更早期诊断和治疗提供依据。本文综述了近年来OSA患者脑结构及功能磁共振成像研究进展,揭示了其神经影像学改变及病理生理学机制,旨在为OSA患者更早期诊断和治疗以及治疗方案的完善提供部分依据。Obstructive sleep apnea(OSA)is the most common sleep disorder with abnormal brain structure and function,leading to a complication of cognitive impairment.In recent years,MRI has been flourishing,including voxel based morphometry(VBM),diffusion tensor imaging(DTI),diffusion tensor imaging analysis along the perivascular space(DTI-ALPS),diffusion kurtosis imaging(DKI),resting state functional magnetic resonance imaging(rs-fMRI),arterial spin labeling(ASL),magnetic resonance spectroscopy(MRS).Especially newly emerging DTI-ALPS and DKI techniques have provided a more novel perspective and broader field of view.DTI-ALPS can evaluate the function of the cerebral lymphatic system non-invasively and reveal the mechanism of lymphatic metabolism disorders in OSA patients,which provide a new perspective for the pathological and physiological mechanism of OSA patients,and provide new ideas for the improvement of treatment plans.DKI could demonstrate microstructural abnormalities of the brain more sensitively before changes might be found with conventional imaging,that provide a basis for earlier diagnosis and treatment of OSA patients.This article reviews the progress of cerebral structural and functional magnetic resonance imaging of OSA patients in recent years,aiming to reveal their neuroimaging changes and pathophysiological mechanisms,and to provide basis for early diagnosis,treatment,and improvement of treatment plans for OSA patients.

关 键 词：阻塞性睡眠呼吸暂停 磁共振成像 静息态功能磁共振成像 沿血管周围间隙扩散张量成像分析 扩散峰度成像 类淋巴系统 

分 类 号：R445.2[医药卫生—影像医学与核医学] R765.2[医药卫生—诊断学]