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目的利用扩散张量成像(DTI)技术检查屈光参差性弱视儿童大脑白质的发育情况,从而探讨其发病机制。设计回顾性病例系列。研究对象15例屈光参差性弱视儿童(均为左眼弱视)及14例年龄、性别相匹配正常儿童。方法利用DTI技术进行检查,用基于体素(Voxel)的形态学测量对病例组与对照组的各向异性分数(FA)图像中的所有Voxel进行逐个比较;用感兴趣区(ROI)方法定位于视放射,计算左右视放射的FA平均值和Voxel数目,比较其在两组研究对象中的差异,分析屈光参差性弱视患者视放射的发育情况。主要指标视觉通路白质结构的FA值和Voxel数目。结果左眼弱视患者的右侧枕叶、顶下小叶、颞叶回下及左侧岛叶FA值较正常者降低,差异有统计学意义(P均=0.00);而双侧丘脑、叶下神经核团外、额叶,右侧枕中回、中央前回、豆状核、壳核,扣带回FA值较正常者升高,差异有统计学意义(P均=0.00)。左眼弱视患者左右两侧视放射的Voxel数目,平均FA值和总FA值较对照组均下降,右侧差异具有统计学意义(P均<0.05),双侧总Voxel数目和FA值均低于正常对照组,差异有统计学意义(P均<0.05),双侧平均FA值也较正常组降低,差异无统计学意义(P均>0.05)。病例组和对照组组内双侧视放射比较发现左侧视放射Voxel数目,平均FA值和总FA值均高于右侧,除对照组平均FA值外,差异均有统计学意义(P均<0.05)。结论屈光参差性弱视患者存在多个视觉相关脑区白质FA值的下降,提示屈光参差性弱视存在着视觉通路神经网络结构的异常;屈光参差性弱视患者双侧视放射FA值和Voxel数目下降,提示此类患者存在双侧视放射的发育不良。
Objective To investigate the development of cerebral white matter in children with anisometropic amblyopia by diffusion tensor imaging (DTI), and to explore its pathogenesis. Design retrospective case series. Participants 15 cases of anisometropic amblyopia children (both left amblyopia) and 14 cases of age and gender matched normal children. Methods The DTI technique was used to examine all Voxel in the anisotropic fraction (FA) images of the case group and the control group using a Voxel-based morphological measurement one by one; the ROI method was used to locate The average FA and Voxel numbers of left and right radiations were calculated in terms of visual radiation, and their differences in the two groups of subjects were compared. The development of apparent radiance in patients with anisometropic amblyopia was analyzed. The main indicators Visual pathway white matter structure FA value and Voxel number. Results The FA values of the right occipital lobe, the inferior parietal lobe, the temporal lobe and the left insula were significantly lower than those of the normal group (P = 0.00) Compared with the normal control group, the values of FA, frontal lobe, right middle occipital gyrus, central anterior lobe, lentiform nucleus, putamen and cingulate gyrus were significantly higher than those of normal controls (P = 0.00). The Voxel number, average FA value and total FA value of left and right amblyopic patients were lower than those of the control group (P <0.05), and the total Voxel number and FA value of both eyes were both low In the normal control group, the difference was statistically significant (P <0.05), bilateral mean FA value was also lower than the normal group, the difference was not statistically significant (P all> 0.05). The bilateral radiofrequency of left visual field in case group and control group was found that the number of Voxel, the average FA value and the total FA value in the left visual field were higher than those in the right side, and the differences were statistically significant except the average FA value in the control group (P <0.05). Conclusions There is a decrease in white matter FA value in multiple visual-related brain regions in patients with anisometropic amblyopia, suggesting abnormalities of visual pathway neural network structure in anisometropic amblyopia. The values of FA and Voxel The number of decline, suggesting that such patients exist bilateral visual dysplasia of radiation.