脑类淋巴系统对脑小血管病患者的白质纤维束的影响研究  

Effect of brain glymphatic system on white matter fiber tracts in patients with cerebral small vessel disease

作　　者：王犇 王余[1] 李宛松 高德瑜 WANG Ben;WANG Yu;LI Wansong;GAO Deyu(MR Room,Tangshan Gongren Hospital,Tangshan,Hebei Province 063000,China;Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]唐山市工人医院磁共振室,河北唐山063000 [2]河北医科大学,河北石家庄050017

出　　处：《实用放射学杂志》2025年第1期22-26,共5页Journal of Practical Radiology

摘　　要：目的探讨脑小血管病(CSVD)患者的皮下白质纤维束的神经突密度指数(NDI)、神经突方向离散度指数(ODI)、各向同性水分子体积分数(Viso)的差异以及CSVD患者的类淋巴系统(GS)对其白质纤维束的NDI值、ODI值、Viso值的影响。方法回顾性选取69例CSVD患者(CSVD组),行常规MRI平扫[3D-T_(1)、T_(2)WI、3D-T_(2)液体衰减反转恢复(FLAIR)]、自旋回波-回波平面成像(SE-EPI)、磁敏感加权成像(SWI)扫描,利用后处理软件测定其脑内29条白质纤维束的NDI、ODI、Viso值。招募35例健康志愿者作为对照组,采用独立样本t检验,比较2组间NDI、ODI、Viso值的差异。采用多重线性回归分别评估CSVD患者的沿血管周围间隙(ALPS)指数与29条白质纤维束NDI、ODI、Viso值的关系。结果与对照组相比,CSVD组的26条白质纤维束的Viso值升高与14条白质纤维束NDI值下降有统计学差异(P_(FDR)<0.05)。多重线性回归中,CSVD患者的ALPS指数的下降与部分白质纤维束NDI值下降有统计学差异(P_(FDR)<0.05),且这些白质纤维束多位于额叶、颞叶。结论神经突方向离散度与密度成像(NODDI)技术可以更好地反映影响CSVD患者的脑白质纤维束完整性的生物学改变,并且能够反映CSVD患者的脑GS对不同白质纤维束的病理生理变化,为临床医师识别CSVD患者的临床表现以及制订治疗方案提供参考。Objective To investigate the differences in neurite density index(NDI),neurite orientation dispersion index(ODI),and volume fraction of isotropic water molecule(Viso)of subcutaneous white matter fiber tracts in patients with cerebral small vessel disease(CSVD),and the effect of the glymphatic system(GS)on NDI,ODI,and Viso values of white matter fiber tracts in patients with CSVD.Methods A total of 69 CSVD patients(CSVD group)were retrospectively selected.All patients underwent conventional plain MRI scans[3D-T_(1),T_(2)WI,3D-T_(2)fluid attenuated inversion recovery(FLAIR)],spin echo-echo planar imaging(SE-EPI),and susceptibility weighted imaging(SWI)scans.The NDI,ODI,and Viso values of 29 white matter fiber tracts in the brain were measured using post-processing software.Thirty-five healthy volunteers were recruited as the control group,and the independent sample t test was used to compare the differences of NDI,ODI,and Viso values between the two groups.Multiple linear regression was used to evaluate the relationship between along the perivascular space(ALPS)index and NDI,ODI,and Viso values of 29 white matter fiber tracts in CSVD patients.Results Compared with control group,CSVD group showed a statistically significant increase in Viso values in 26 white matter fiber tracts and decrease in NDI values in 14 white matter fiber tracts(P_(FDR)<0.05).In multiple linear regression,the decrease of ALPS index in CSVD patients was found to be statistically different from that of NDI values in certain white matter fiber tracts(P_(FDR)<0.05)and primarily located in the frontal and temporal lobes.Conclusion Neurite orientation dispersion and density imaging(NODDI)technology is more effective in identifying the biological differences,which impact the integrity of white matter fiber tracts in patients with CSVD.Furthermore,it reflects the pathophysiological changes of the brain GS on different white matter fiber tracts in CSVD patients.This provides valuable insights for recognizing the clinical manifestations of CSVD and de

关 键 词：脑小血管病 磁共振成像 类淋巴系统 白质纤维束 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]