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目的利用基于体素的分析方法对震颤麻痹型多系统萎缩(MSA-P)患者的弥散张量成像(DTI)数据进行研究,探索其脑内微结构改变。资料与方法入组24例MSA-P患者(病例组)及26例健康志愿者(对照组),分别行全脑结构成像及弥散张量成像。比较两组各向异性分数(FA)图和平均扩散率(MD)图,得出反映病例组与对照组差异的统计参数图。结果与对照组相比,病例组FA值减低累及双侧脑干、小脑半球、岛叶、顶叶、额叶、颞叶及枕叶,差异有统计学意义(P<0.005),其中白质受累较灰质显著;MD值在双侧脑干、小脑半球、基底节、岛叶、额叶、颞叶及枕叶处较对照组升高,差异有统计学意义(P<0.005)。结论 DTI技术可以敏感地通过显示MSA-P患者脑内微结构的改变反映其受累情况,基于体素的分析方法有助于客观展示全脑受累情况。
Objective To study the diffusion tensor imaging (DTI) data of patients with Parkinsonism paralysis-type multiple system atrophy (MSA-P) by using the voxel-based analysis method and explore the changes of the brain micro-structure. Materials and Methods Twenty-four patients with MSA-P (case group) and 26 healthy volunteers (control group) were enrolled in this study. Whole-brain structure imaging and diffusion tensor imaging were performed. The anisotropy score (FA) and the average diffusivity (MD) were compared between the two groups to get the statistical parameter map which reflected the difference between the case group and the control group. Results Compared with the control group, the decrease of FA value in the case group was statistically significant (P <0.005), including bilateral brain stem, cerebellar hemisphere, insula, parietal lobe, frontal lobe, temporal lobe and occipital lobe (P <0.005). Compared with control group, MD value increased significantly in bilateral brainstem, cerebellar hemisphere, basal ganglia, insula, frontal lobe, temporal lobe and occipital lobe. Conclusion DTI can sensitively reflect the involvement of MSA-P in brain tissue. The voxel-based analysis method can help to objectively display whole brain involvement.