长新冠患者纵向海马亚结构体积变化与认知的关系  

Relationship between Volume Changes of Longitudinal Hippocampal Substructure and Cognition in Patients with Long COVID-19

作　　者：贺程成 谢晶美 郭宝琴 刘浩[1] 朱志敏 陈苗苗 李华[1,3] 张明 HE Cheng-cheng;XIE Jing-mei;GUO Bao-qin;LIU Hao;ZHU Zhi-min;CHEN Miao-miao;LI Hua;ZHANG Ming(Image Center of Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,Shaanxi Province,China;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,Shaanxi Province,China;Yulin City First Hospital,Yulin 719000,Shaanxi Province,China)

机构地区：[1]西安交通大学附属第一医院榆林医院影像中心,陕西榆林719000 [2]西安交通大学第一附属医院,陕西西安710000 [3]榆林市第一医院,陕西榆林719000

出　　处：《中国CT和MRI杂志》2025年第2期46-49,共4页Chinese Journal of CT and MRI

基　　金：陕西省卫生健康脑科学与影像新技术科研创新平台(2023PT-09)。

摘　　要：目的 基于磁共振3D-T1WI序列纵向分析长新冠患者各海马亚区的结构变化,探讨长新冠患者各海马亚区结构与认知变化的关系。方法 前瞻性收集21例长新冠患者COVID-19病毒阳转阴1个月后认知量表及3D-T1影像资料并在3个月后再次重复采集相关资料。基于AI全自动分割海马并得到各海马亚区结构容积参数。根据症状持续时间分为急性期与慢性期两组。使用配对样本t检验或配对样本秩和检验比较两组海马亚区体积差异,采偏相关分析前后两次各量表差值与各海马亚区前后差值的相关性。结果 与急性期相比,慢性期双侧海马体总体积差异显著增加,双侧海马头、双侧海马角1、双侧海马分子层、双侧海马杏仁核过渡区、右侧海马体、右侧海马角4显著大于急性期组,而右侧侧齿状回显著小于急性期组。左侧CA1及右侧CA4前后脑体积变化与认知变化成负相关。结论 基于3D-T1WI可发现长新冠患者总体认知能力下降且双侧海马部分亚区体积异常,左侧CA1与右侧CA4亚海马亚区与总体认知功能成负相关。Objective To longitudinally analyze the structural changes of hippocampal subregions in long COVID-19 patients based on magnetic resonance 3D-T1WI sequence, and to explore the relationship between hippocampal subregions and cognitive changes in long COVID-19 patients. Methods The cognitive scale and 3D-T1 imaging data of 21 patients with long COVID-19 were prospectively collected 1 month after COVID-19 virus positive conversion, and the relevant data were collected again 3 months later. The hippocampal subregions were segmented automatically based on AI and the structure and volume parameters of each hippocampal subregion were obtained. According to the duration of symptoms,patients were divided into two groups: acute phase and chronic phase. The volume differences of hippocampal subregions of the two groups were compared by paired sample t-test or paired sample rank sum test. Partial correlation analysis was used to analyze the correlation between the volume changes of hippocampal subregions in acute and chronic phase and the cognitive differences before and after. Results Compared with the acute phase, the total volume of bilateral hippocampus in the chronic phase was significantly increased. Bilateral hippocampal head, bilateral hippocampal horn 1, bilateral hippocampal molecular layer, bilateral hippocampal amygdala transitional area, right hippocampal body and right hippocampal horn 4 were significantly larger than those in the acute group, while the right dentate gyrus was significantly smaller than that in the acute group. The changes of brain volume before and after left CA1 and right CA4 were negatively correlated with cognitive changes. Conclusion Dased on 3D-T1WI, it can be found that the overall cognitive ability of long COVID-19 patients is decreased and the volume of bilateral hippocampal subregions is abnormal. There is a negative correlation between left CA1 and right CA4 subhippocampal subregions and overall cognitive function.

关 键 词：新型冠状病毒肺炎 长新冠 脑结构 认知 海马 定量分析 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563.1[医药卫生—诊断学]