磁共振扩散张量成像在慢性酒精中毒性脑病的初步临床应用

Primary Clinical Application of Diffusion Tensor Imaging in Chronic Alcoholism Encephalopathy

目的:探讨磁共振扩散张量成像(DTI)在慢性酒精中毒性脑病(CAE)中的应用价值,为CAE的早期诊断提供客观依据。方法:对15例CAE患者(男11例,女4例,年龄33-63岁,平均年龄46岁)及18例健康志愿者(男女各半,年龄32-71岁,平均年龄44.5岁)行颅脑常规MRI和DTI扫描,在获得的DTI原始图像上测量额叶白质、半卵圆中心、胼胝体膝部、压部、丘脑等5个感兴趣区(ROI区)的各向异性分数FA值,并与健康对照组进行对比,分析CAE患者各临床指标与FA值的相关性,明确CAE中影响DTI参数的主要因素。结果:CAE组胼胝体膝部、压部、半卵圆中心和额叶白质的FA值均低于健康对照组,CAE男性组FA值低于女性组,FA值的减低与患者年龄无明显相关,与饮酒史、日饮酒量有密切关系。结论:DTI可在早期发现CAE患者主要传导通路受损程度,为酒精性脑损害的定位诊断、病程监测,评估疗效及预后提供更为精确的信息。

Objective： To investigate the application value of diffusion tensor imaging （DTI） in chronic alcoholism encephalopathy（CAE）, and thereby to provide obiective evidences for the early diag- nosis of CAE. Methods. Fifteen cases of CAE patients （11 males and 4 females, aged from 33 to 63 years old） and 18 healthy volunteers were performed conventional brain MRI and DTI. The ffactional anisotropy （FA） values were measured by DTI in the white matter of fontal lobe, centrum semiovale, genu of corpus callosum, splenium of corpus callosum and cerebral ganglion with five regions of interest （ROD and compared with those of the healthy volunteers. The relationship between the clinical indexes and FA were analyzed in CAE patients to identify the main factor effecting on FA. Results： FA values of CAE group＇s in the genu corpus callosum, splenium of corpus callosum, centrum semiovale and white matter of ffontal lobe were lower than those of the healthy control group. FA values in the male CAE patients were lower than those of the fe- male patients and there was no significantly correlation ship between the decrease of FA values and the patient＇s age. However, the decrease of FA values was closely related to the history of drinking and alcohol consumption in one day. Conclusion. DTI might play a key role in the early detection of the damage degree of the major conducting access. The primary research implied that DTI might provide more accurate informations for locating diagnosis of alcoholism encephalopathy, monitoring the course of disease and assessing the therapeutic effect and the prognosis.