摘要
目的应用扩散张量成像(DTI)观察急性CO中毒患者脑白质结构的改变,应用影像技术量化脑白质损害程度,推测急性CO中毒迟发性脑病相关机制。方法对25例急性CO中毒患者和25例性别与年龄相匹配的健康志愿者进行头部磁共振DTI扫描,采用基于纤维束示踪的空间统计方法(TBSS),分析急性CO中毒患者脑白质平均扩散系数(MD)、各向异性分数(FA)的变化,探讨其与患者认知功能障碍间的相关性。结果与健康对照组对比,急性CO中毒患者组的放射冠、胼胝体的MD增高而FA降低(P<0.05);双侧上纵束,内、外囊,丘脑和脑干的MD增加但无FA改变(P<0.05)。与临床量表分数相关性比较发现,差异脑区FA值与MMSE评分呈一定正相关(P<0.05),差异脑区MD值与MMSE评分呈一定负相关(P<0.05)。结论DTI准确反映急性CO中毒导致脑内白质广泛的血管源性水肿以及脑白质纤维束完整性损害,可能量化反应病情缺氧脑损伤程度、预测迟发性脑病,同时DTI参数的改变还可以一定程度反映患者认知障碍情况。
Objective To observe the white matter structure in patients with acute CO poisoning by diffusion tensor imaging(DTI),and quantify the degree of white matter damage by imaging techniques and speculate the mechanism of delayed encephalopathy in patients with acute CO poisoning.Methods Twenty-five patients with acute CO poisoning and twenty-five healthy volunteers matched by sex and age were scanned by head magnetic resonance DTI.The changes of mean diffusion coefficient(MD)and anisotropic fraction(FA)of white matter in patients with acute CO poisoning were analyzed by TBSS,and the correlation between them and the cognitive impairment were discussed.Results Compared with the healthy control group,MD of corona radiata and corpus callosum increased and FA decreased in patients with acute CO poisoning(P<0.05);the MD of bilateral superior longitudinal tract,internal and external capsule,thalamus and brainstem increased but there was no FA change(P<0.05).Compared with the scores of clinical scale,the FA values of different brain regions were positively correlated with MMSE and Mo CA scores(P<0.05),while the MD values of different brain regions were negatively correlated with MMSE and Mo CA scores(P<0.05).Conclusion DTI accurately reflects the extensive vasogenic edema of white matter and the damage of white matter fiber bundle integrity caused by acute CO poisoning.It may quantify the degree of hypoxic brain damage and predict delayed encephalopathy.At the same time,the change of DTI parameters can also reflect the degree of cognitive impairment of patients.
作者
伍清宇
蒋雯茜
占雅如
何来昌
刘萌
谭永明
WU Qingyu;JIANG Wenqian;ZHAN Yaru(Department of Medical Imaging,First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi Province 330000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第1期31-35,共5页
Journal of Clinical Radiology
基金
2018江西省研究生创新专项资金项目(编号:YC2018-S109)
江西省卫生健康委员会科技计划(编号:20191040)。
