可逆性后部脑病综合征病理生理学机制  

Pathophysiological mechanism of posterior reversible encephalopathy syndrome

作　　者：金鑫 王燕 刘斯平 王志兵 张志强 JIN Xin;WANG Yan;LIU Siping;WANG Zhibing;ZHANG Zhiqiang(Department of Radiology,Yangzhou Hospital of Traditional Chinese Medicine,Yangzhou 225002,China;Department of Radiology,Affiliated Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China)

机构地区：[1]扬州市中医院影像科,江苏扬州225002 [2]南京大学医学院附属金陵医院(东部战区总医院)放射科,江苏南京210002

出　　处：《中国医学影像技术》2025年第3期404-408,共5页Chinese Journal of Medical Imaging Technology

基　　金：2022年度扬州市科技计划项目(YZ2022087)。

摘　　要：目的采用规范性分析策略探讨可逆性后部脑病综合征(PRES)空间分布频率图与脑微血管密度图、脑血流(CBF)图、脑代谢影像学标准模板及人脑空间基因转录图谱的相关性,分析PRES病理生理学机制。方法回顾性分析184例PRES颅脑MRI,于T1WI勾画病灶ROI并将其配准至蒙特利尔神经学研究所(MNI)标准空间,叠加后获得PRES空间分布频率图;利用空间相关分析分别计算PRES累及部位空间分布频率图与基于大样本所获脑微血管密度图、CBF图及脑代谢影像学标准模板的相关性;基于艾伦人脑图谱基因表达数据解码潜在相关基因表达,观察其与PRES累及部位空间分布的相关性。结果PRES累及部位空间分布频率图与脑微血管密度、CBF及各神经递质分布均无明显相关(P均>0.05)。PLS1加权基因、VEGF-A基因、AQP-4基因及RGS2基因均与PRES累及部位的空间分布相关(r=-0.363~0.653,P均<0.05),以KCNAB3基因权重最高(Z=17.288)。结论PRES风险或保护基因在大脑区域的空间模式与PRES累及部位分布具有相关性,倾向于支持用于解释PRES发生、发展的精氨酸抗利尿激素(AVP)理论。Objective To explore the correlations of spatial distribution frequency map of posterior reversible encephalopathy syndrome(PRES)and cerebral microvascular density map,cerebral blood flow(CBF)map,standard template of cerebral metabolic imaging and the spatial gene transcription map of human brain based on normative analysis strategy,and to analyze the pathophysiological mechanisms of PRES.Methods Cerebral MRI data of 184 patients with PRES were retrospectively analyzed.ROI of the lesions were delineated on T1WI,then registered to Montreal Neurological Institute(MNI)standard space.The spatial distribution frequency map of PRES lesions were obtained with superposition.Spatial correlation analysis were performed to observe correlations of spatial distribution frequency map of PRES and the cerebral microvascular density map,CBF map and standard template of cerebral metabolic imaging based on large sample.The potential related gene expressions were decoded based on gene expression data of Allen human brain atlas,and the correlations of spatial parts of PRES and those expressions were observed.Results No significant correlation was found between spatial distribution frequency map of PRES and cerebral microvascular density,CBF nor distribution of neurotransmitters(all P>0.05).PLS1 weighted genes,VEGF-A gene,AQP-4 gene and RGS2 gene were all correlated with spatial distribution of PRES(r=-0.363—0.653,all P<0.05),among which KCNAB3 gene had the highest weight(Z=17.288).Conclusion The spatial patterns of PRES risk or protective genes in brain regions were correlated with regional distribution of PRES lesions,which was consistent with arginine vasopressin(AVP)theory of the occurrence and development of PRES.

关 键 词：后部白质脑病综合征 病理生理学 磁共振成像 

分 类 号：R741.02[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]