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目的研究无先兆偏头痛患者大脑结构和功能异常的MRI表现。方法选取30例无先兆偏头痛患者作为观察组,同期25例健康志愿者作为对照组。Signa Excite 3.0 T磁共振扫描仪,采用平面回波成像序列采集对象静息态功能MRI图像,采用单次激发回波平面成像序列采集脑白质DTI图像。采用肯德尔系数评估静息态局部一致性,采用基于纤维束追踪空间统计分析技术(TBSS)分析脑白质纤维的分数各项异性(FA)、平行弥散系数(RD)、轴向弥散系数(AD)、以及平均弥散系数(MD)。结果与对照组比较,观察组患者多个脑区存在局部一致性降低,包括左侧前后扣带回、左侧颞下回、左侧梭状回、右侧中央前后回、右侧额中回、右侧舌回局部一致性减弱(FEW校正,P<0.05)。观察组患者双侧大脑脚、双侧内囊后肢、右侧内囊前肢、右侧上纵束、右侧胼胝体体部和压部、右侧上放射冠和后放射冠、左侧扣带的FA值显著降低(FEW校正,P<0.05);双侧上放射冠和后放射冠、双侧扣带、双侧丘脑后辐射、双侧上纵束、右侧大脑脚、右侧内囊前后肢以及右侧胼胝体体部和压部的RD值显著升高(FEW校正,P<0.05);胼胝体体部和压部,右侧上放射冠和后放射冠,以及右侧上纵束的MD值显著升高(FEW校正,P<0.05);两组各脑区的AD值无显著性差异(FEW校正,P>0.05)。结论无先兆偏头痛患者大脑静息态局部一致性和脑白质纤维束存在改变,且明显区别于健康志愿者。
Objective To investigate the MRI findings of brain structure and dysfunction in migraineurs without aura. Methods Thirty patients without aura were selected as observation group and 25 healthy volunteers as control group. The Signa Excite 3.0 T magnetic resonance scanner used planar echo imaging sequences to acquire rest state MRI images of the subject and acquired white matter DTI images using a single-shot echo planar imaging sequence. Kendall coefficient was used to evaluate the local consistency of resting state. Fetal white matter fiber fractional anisotropy (FA), parallel diffusivity (RD), axial diffusion coefficient (AD) were calculated by TBSS (fiber bundle tracking spatial statistical analysis technique) ), And mean diffusivity (MD). Results Compared with the control group, there was a reduction in local consistency in multiple brain regions in the observation group, including left anterior-posterior cingulate gyrus, left inferior temporal gyrus, left fusiform gyrus, right middle anteroposterior gyrus, right middle frontal gyrus , Local consistency of right lingual tongue lesion (FEW correction, P <0.05). In the observation group, bilateral cerebral peduncle, bilateral internal capsule hindlimb, right internal capsule forelimb, right superior longitudinal bundle, right corpus callosum body and pressure, right upper corona and posterior corona radiata, left fascia FA value decreased significantly (FEW correction, P <0.05); bilateral upper canopy and posterior crowns, bilateral cingulate, bilateral thalamic posterior radiation, bilateral superior longitudinal bundle, The RD values of the hindlimb and the right corpus callosum were significantly increased (FEW corrected, P <0.05); the corpus callosum body and pressure, the right upper corona and posterior radial coronal, and the right superior longitudinal MD (FEW correction, P <0.05). There was no significant difference in AD values between the two groups (FEW correction, P> 0.05). Conclusions There is a change in the local consistency of resting state and brain white matter fiber bundles in patients without aura migraine, which are obviously different from those in healthy volunteers.