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目的:探讨基于体素内不相干运动扩散加权成像(IVIM-DWI)研究围产期HIV感染无症状型青少年脑扩散与灌注信息可行性及其变化特征。方法:收集临床确诊围产期HIV感染无症状青少年18例(HIV~+组)和来自艾滋病家庭年龄、性别匹配HIV阴性对照组(HIV-组)17例。受试者均行常规MR脑平扫和IVIM-DWI检查。IVIM-DWI选取7个b值,经MITK软件拟合和MRICroN软件测量获得双侧尾状核和额叶白质IVIM参数值的平均值(D值、D*值和f值)。独立样本t检验、Pearson相关性分析IVIM参数值与CD4~+T淋巴细胞计数、CD4/CD8比值的相关性。结果:与对照组比较,HIV~+组尾状核和额叶白质灌注扩散系数D*值有显著降低(P<0.01);D*值与CD4~+T淋巴细胞计数、CD4/CD8比值呈显著正相关(尾状核r分别为0.719和0.640;额叶白质r分别为0.440和0.546;P<0.05)。HIV~+组尾状核和额叶白质D值和f值差异无统计学意义,与CD4~+T淋巴细胞计数、CD4/CD8比值无显著相关性。结论:IVIM-DWI能敏感检测围产期HIV感染无症状型青少年尾状核和额叶白质微循环灌注不相干运动D*值的变化,D*值可能作为HIV感染脑部变化早期和进展评估的可视化标志物。
Objective: To investigate the feasibility and change characteristics of brain diffusion and perfusion information in asymptomatic HIV-infected adolescents with perinatal HIV infection based on the in-voxel incoherent diffusion weighted imaging (IVIM-DWI). Methods: Eighteen infants (HIV ~ + group) and 17 HIV-negative controls (HIV-group) from AIDS-infected families and HIV-matched controls were enrolled in this study. Subjects underwent routine MR brain plain scan and IVIM-DWI examination. Seven b-values were selected from IVIM-DWI and the mean (D value, D * value, and f-value) of both bilateral caudate nucleus and frontal white matter IVIM parameter values were measured by MITK software fitting and MRICroN software. Independent sample t test, Pearson correlation analysis of IVIM parameters and CD4 ~ + T lymphocyte count, CD4 / CD8 ratio. Results: Compared with the control group, the diffusion coefficient D * of the caudate nucleus and the frontal white matter in HIV ~ + group was significantly decreased (P <0.01). The D * value and CD4 ~ + T lymphocyte count and CD4 / CD8 ratio Significantly positive correlation (caudate nucleus r were 0.719 and 0.640; frontal white matter r were 0.440 and 0.546; P <0.05). There were no significant differences in the values of D and f in the nuclei of caudate nucleus and frontal lobe in HIV ~ + group, and there was no significant correlation between CD4 ~ + T lymphocyte count and CD4 / CD8 ratio. Conclusion: IVIM-DWI can detect the change of D * value of perinatal HIV-infected asymptomatic juvenile caudate nucleus and frontal white matter perfused with irrelevant motility. The D * value may be used as an early assessment of brain infection and progress in HIV infection Visual marker.