首发精神分裂症患者脑形态CT研究

Computed Tomography Study of the Brain Morphology of Patients with First-episode Schizophrenia

目的探讨首发精神分裂症(FES)患者脑形态CT变化。方法回顾性分析100例经临床确诊的FES患者,符合ICD10诊断标准、首次发病、首次经抗精神药物治疗且病程≤2年,并和对照组(n=100)进行对照。所有研究对象经头部CT扫描获得脑部CT图像,测量、计算及观察有关数据和指标,经过统计学处理后分析FES患者脑形态CT改变。结果 FES患者反映脑室扩大、脑萎缩的指标发生改变,如FHI、VBR、HZ等增大;PFAI、CMI等减小。表现为侧脑室、第三脑室适度扩大、脑沟扩大,外侧裂增宽并且表现出RASF、弥漫性及局限性脑萎缩等脑形态CT改变,松果体钙化发生率明显增加且过早钙化。结论 FES患者大脑组织的丧失导致其出现脑体积减小、脑室扩大、脑萎缩等异常,进一步证明了FES患者大脑病因学假说中的神经发育假说,为精神分裂症病因学研究提供重要的影像学依据。

Objective To explore the computed tomography（CT） changes of the brain morphology of patients with first-episode schizophrenia（FES）.Methods 100 cases that diagnosed FES by clinical were analyzed retrospectively.According to the diagnostic criteria of ICD10,first attacked,first treated by antipsychotic drug and the duration of disease less than two years were enrolled.Meanwhile,they were compared with the healthy matched groups（n=100）.All subjects received brain CT scan and the CT images were obtained.Relevant data and index were measured,calculated and observed.CT changes of the brain morphology of patients with FES were analyzed by statistical processing.Results The index indicated the ventricular dilatation and cerebral atrophy changes in patients of FES,such as the number of FHI,VBR,HZ increased;the number of PFAI and CMI decreased.The lateral and the third ventricles had a modest expansion,the sulci enlarged,the lateral fissure widened and presented RASF,the cerebral lobe was diffuse and limitations atrophied.The incidence of pineal calculus was obvious increased and prematured.Conclusion FES patients had the decrease of the brain volume,abnormal dilatation of ventricular and cerebral atrophy as a result of the brain tissue lose,which was the further evidence of neurodevelopment hypothesis of FES brain.The results of the research can provide important imaging evidence for the schizophernia etiology research.