库欣病患者杏仁核亚区体积及形状改变的结构像磁共振成像研究  

A structural magnetic resonance imaging study of amygdala subfield volumes and shape changes in Cushing's

作　　者：冯哲斌 周涛[1] 何堃宇 许军鹏 尚国松 王鹏[1] 余新光[1] 张剑宁 张艳阳[1] disease FENG Zhebin;ZHOU Tao;HE Kunyu;XU Junpeng;SHANG Guosong;WANG Peng;YU Xinguang;ZHANG Jianning;ZHANG Yanyang(Department of Neurosurgery,The First Medical Center,Chinese PLA General Hospital,Beijing 100086,China;Department of Neurosurgery,The 942nd Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Yinchuan 750000,China)

机构地区：[1]解放军总医院第一医学中心神经外科医学部,北京100086 [2]解放军联勤保障部队第九四二医院神经外科,宁夏银川750000

出　　处：《空军军医大学学报》2025年第3期330-336,共7页Journal of Air Force Medical University

基　　金：国家自然科学基金青年科学基金(82001798);解放军总医院“3+1”青年科技英才培育项目(20230403)。

摘　　要：目的探讨库欣病(CD)患者杏仁核亚区体积及形态学改变,以及亚区体积与皮质醇等激素水平、神经心理评估量表评分的相关性。方法纳入75例CD患者与49例健康对照,进行结构像磁共振平扫,检测各时段皮质醇、促肾上腺皮质激素水平,并对所有研究对象进行综合神经心理评估。采用FreeSurfer图像分析软件进行杏仁核亚区体积及表面形状测量,采用混合设计方差分析、单因素方差分析、偏相关分析等分析方法评估CD患者杏仁核亚区体积改变及其与其他临床指标的相关性。结果CD患者双侧整体杏仁核、基底核、副基底核、前杏仁核区域、皮质核以及皮质杏仁核过渡区域的体积明显减小(P<0.05),双侧杏仁核表面弥漫性萎缩凹陷,背外侧、头侧表面尤著。偏相关分析提示CD患者右侧皮质核体积与16∶00皮质醇浓度存在显著负相关。结论CD患者的双侧杏仁核及其亚区存在显著体积及形态学改变,且特定亚区体积与激素水平存在相关性。Objective To explore the volumetric and morphological alterations in amygdala subfields and the correlation between the subfield volume and hormone levels and neuropsychological scale scores in Cushing's disease(CD)patients.Methods Seventy-five CD patients and forty-nine healthy controls were included for a structural magnetic resonance imaging scan and detections of cortisol and adrenocorticotrophic hormone levels at various time points.A comprehensive neuropsychological assessment was conducted for all subjects.FreeSurfer,an image analysis software,was used to measure the volume and surface morphology of amygdala subfields.Mixed-design analysis of variance,one-way analysis of variance,and partial correlation analysis were used to evaluate the volumetric alterations in amygdala subfields in CD patients and their associations with other clinical indicators.Results The volumes of bilateral global amygdala,basal nucleus,accessory basal nucleus,anterior amygdaloid area,cortical nucleus,and cortico-amygdaloid transition area were significantly reduced in CD patients(P<0.05).The surface of bilateral amygdala presented diffuse atrophy and depression,particularly in the dorsolateral and cephalic regions.Partial correlation analysis indicated a significant negative correlation between the volume of the right cortical nucleus and the cortisol concentration at 16:00.Conclusion CD patients exhibit significant volumetric and morphological alterations in the bilateral amygdala and its subfields,with the volume of specific subfields being correlated with hormone levels.

关 键 词：库欣病 杏仁核亚区 FREESURFER 结构磁共振 形状分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R586[医药卫生—诊断学]