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目的应用扩散张量成像(DTI)和氢质子磁共振波谱成像(~1H-MRS)评估肝豆状核变性(HLD)患者脑灰质核团及白质的微观结构损害。方法选取HLD患者26例及正常对照组20名行DTI及~1H-MRS成像,比较两组不同脑区部分各向异性值(FA)、平均扩散系数(ADC)、扩散张量本征(E1、E2、E3)值及NAA/Cr、Cho/Cr、NAA/Cho比值的差异。结果 HLD患者双侧壳核及丘脑的FA及ADC值高于正常组,其中壳核差异有统计学意义(P<0.05),而双侧丘脑差异无统计学意义(P>0.05);双侧额叶白质及胼胝体压部FA值降低,ADC值升高,与正常组对比差异均有统计学意义(P<0.05);HLD组各兴趣区本征值均高于对照组,其中双侧壳核E1、E2、E3值、双侧丘脑E1值、双侧额叶白质及胼胝体压部E2、E3值差异均有统计学意义(P<0.05);HLD组双侧壳核、双侧丘脑及胼胝体压部的NAA/Cr比值低于正常对照组,差异有统计学意义(P<0.05)。结论 DTI结合~1H-MRS技术可以提供HLD患者脑实质的代谢及扩散量化指标,更真实地反映脑实质损害的程度。
Objective To evaluate the microstructure damage of gray matter nucleus and white matter in patients with hepatolenticular degeneration (HLD) by diffusion tensor imaging (DTI) and hydrogen proton magnetic resonance spectroscopy (~ 1H-MRS). Methods DTI and 1H-MRS imaging were performed in 26 HLD patients and 20 normal controls. The anisotropy (FA), mean diffusivity (ADC), diffusion tensor intrinsic , E2, E3) and NAA / Cr, Cho / Cr, NAA / Cho ratio. Results The FA and ADC values of bilateral putamen and thalamus in HLD patients were significantly higher than those in normal subjects (P <0.05), but there was no significant difference in bilateral thalamus (P> 0.05). The bilateral The values of FA in frontal white matter and callus of the corpus callosum decreased and the ADC values increased, which were significantly different from the normal group (P <0.05). The eigenvalues of each region of interest in HLD group were higher than those in control group There were significant differences in E2, E3 values between nucleus E1, E2, E3, bilateral thalamus E1, bilateral frontal white matter and corpus callosum (P <0.05) The NAA / Cr ratio of the corpus callosum was lower than that of the normal control group, with significant difference (P <0.05). Conclusions DTI combined with ~ 1H-MRS can provide quantitative and quantitative indicators of brain parenchyma metabolism and diffusion in HLD patients, and more accurately reflect the extent of brain parenchymal damage.