摘要
目的探讨轻度脑外伤(mTBI)后患者丘脑的代谢变化特点,分析其与外伤后认知功能障碍的相关性。资料与方法对2014年9月-2017年3月于盐城市第一人民医院神经外科住院治疗的31例mTBI患者(mTBI组)和31例健康志愿者(对照组)双侧丘脑行单体素质子磁共振波谱(~1H-MRS)成像,并检测N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)浓度,比较两组双侧丘脑NAA/Cr、Cho/Cr比值的差异,并分析m TBI组双侧丘脑NAA/Cr、Cho/Cr比值与蒙特利尔认知评估量表(MoCA)总分及各子项评分的相关性。结果 31例m TBI患者中,27例(87.09%)存在空间与执行能力障碍,24例(77.41%)存在记忆损害,22例(70.96%)存在注意力损害;m TBI组MoCA总评分、视空间与执行能力、记忆力、注意力、语言能力评分均低于对照组,差异有统计学意义(P均<0.05);m TBI组双侧丘脑NAA/Cr比值也低于对照组(左侧:2.29±0.11比2.43±0.16,t=2.11,P=0.01;右侧:2.17±0.15比2.31±0.32,t=2.33,P=0.03),两组Cho/Cr比值差异无统计学意义(P>0.05)。Spearman相关分析显示,m TBI组双侧丘脑NAA/Cr比值与MoCA总评分、视空间与执行能力、记忆力、注意力、语言能力评分均有相关性(r_(左侧)=0.89、0.61、0.63、0.44、0.56,r_(右侧)=0.77、0.44、0.56、0.51、0.44,P均<0.05);Cho/Cr比值与上述各临床特征均无显著相关性(P均>0.05)。结论 ~1H-MRS可以敏感地检测出m TBI患者丘脑异常代谢变化,这种代谢异常与患者认知功能损害相关。
Purpose To explore patients’metabolic changes of thalamus after experiencing mild traumatic brain injury(mTBI),and to understand its correlation with post-traumatic cognitive dysfunction.Materials and Methods Bilateral thalami of 31 mTBI patients(mTBI group)and 31 healthy volunteers(control group)hospitalized in Department of Neurosurgery,Yancheng First People's Hospital from September 2014 to March 2017 received 1H Magnetic resonance spectroscopy(1H-MRS),and concentrations of N-acetyl aspartate(NAA),choline(Cho)and creatine(Cr)were detected.The difference concerning the ratio of NAA/Cr and Cho/Cr in bilateral thalami between the two groups was compared,the correlations between the NAA/Cr and Cho/Cr ratios of the bilateral thalami in the mTBI group and the total score of Montreal Cognitive Assessment(MoCA)Scale as well as scores of each sub-item were analyzed.Results Among 31 mTBI patients,27 patients(87.09%)had space and executive dysfunction,24 patients(77.41%)had memory impairment,and 22 patients(70.96%)had attention impairment;MoCA total score,visuospatial and executive function,memory,attention,and language ability scores in the mTBI group were all statistically lower than those in the control group(P<0.05).The NAA/Cr ratio of bilateral thalami in the mTBI group was also lower than that in the control group(left side:2.29±0.11 vs.2.43±0.16,t=2.11,P=0.01;right side:2.17±0.15 vs.2.31±0.32,t=2.33,P=0.03),but there was no statistical significance concerning the difference in Cho/Cr ratio between the two groups(P>0.05).Spearman correlation analysis suggested that NAA/Cr ratio of bilateral thalami in the mTBI group was correlated with MoCA total score,visuospatial and executive function,memory,attention,and language ability scores(rleft=0.89,0.61,0.63,0.44,0.56,respectively,rright=0.77,0.44,0.56,0.51,0.44,P<0.05).There was no significant correlation between the Cho/Cr ratio and the above clinical features(P>0.05).Conclusion 1H-MRS can sensitively detect abnormal metabolic changes of thalamus in mTBI patients,and such metabolic abnormality is associated with patients’cognitive impairment.
作者
沈祥春
汪丽娜
周仪
肖勇
SHEN Xiangchun;WANG Lina;ZHOU Yi;XIAO Yong(Yancheng First People's Hospital,Yancheng 224005,China;)
出处
《中国医学影像学杂志》
CSCD
北大核心
2018年第10期737-741,共5页
Chinese Journal of Medical Imaging
关键词
脑损伤
磁共振成像
磁共振波谱学
丘脑
认知障碍
Brain injuries
Magnetic resonance imaging
Magnetic resonance spectroscopy
Thalamus
Cognition disorders
