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目的探讨磁共振DTI及其纤维束示踪(FT)技术对人类免疫缺陷病毒相关的颈髓损伤早期诊断价值。方法 25例临床无症状HIV阳性患者与25例统计学资料匹配的正常志愿者行3.0 T MRI常规和DTI扫描,统计分析C4/5层面水平(白质束前索、侧索、后索)和对照组ROI相关参数(ADC值、FA值、λ1、λ2、λ3),并重建FT图。结果 HIV阳性组颈髓ROI区白质侧索λ2值、λ3值较正常组增高,差异具有显著统计学意义(P<0.05);HIV阳性组颈髓ROI区白质前索、后索ADC值、λ1值、λ2值、λ3值较正常组增高,侧索的λ1值较正常组增高,FA值较正常组降低,但差异均无统计学意义(P>0.05)。HIV阳性组FT技术部分显示颈髓白质纤维束不同程度稀疏、移位或扭曲征象。结论 DTI能早期发现无症状HIV阳性患者颈髓损伤的细微结构改变,但尚未有足够的证据支持DTI可作为人类免疫缺陷病毒相关颈髓损伤的临床诊断工具。
Objective To investigate the early diagnostic value of magnetic resonance DTI and fiber tracing (FT) technique for human immunodeficiency virus-associated cervical spinal cord injury. Methods Twenty-five patients with clinically asymptomatic HIV positive and 25 normal volunteers matched with statistical data underwent 3.0 T MRI routine and DTI scanning. Statistical analysis was performed on C4 / 5 level (white matter anterior, lateral and posterior) and control Group ROI-related parameters (ADC value, FA value, λ1, λ2, λ3) and reconstruct the FT plot. Results There was a statistically significant difference in λ2 and λ3 values of white matter sidelobes in ROI of HIV-positive patients (P <0.05). ADC values of white matter anterior lobe and posterior lobe of HIV-positive patients in ROI of cervical cord were λ1 The values of λ2 and λ3 were higher than those of the normal group. The λ1 of the lateral cord was higher than that of the normal group, and the FA value was lower than that of the normal group (P> 0.05). The FT-technology section of the HIV-positive group showed signs of sparse, displaced or distorted signs of cervical white matter fiber bundles. Conclusions DTI can detect early subtle structural changes of cervical spinal cord injury in asymptomatic HIV positive patients. However, there is not enough evidence to support DTI as a clinical diagnostic tool for human immunodeficiency virus-related cervical spinal cord injury.