核磁共振扩散张量成像技术在一氧化碳中毒迟发型脑病中的临床研究

Clinical study of the diffusion tenson imaging in patient with delayed encephalopathy after carbon monoxide poisoning

目的研究急性一氧化碳中毒在不同脑白质区和不同灰质区核磁共振扩散张量成像技术(diffusion tensonimaging,DTI)平均扩散系数(average diffusion coefficent,ADC)值与各向异性分数(fractional anisotropy,FA)值,与急性一氧化碳迟发性脑病(delayed encephalopathy after acute carbon monoxide poisoning,DEACMP)相关性。方法对一氧化碳中毒后30例并发DEACMP和35例未发生DEACMP患者行核磁共振DTI扩散特征参数ADC值与FA值,进行总结分析。结果根据DTI的扩散特征参数,能够监测一氧化碳中毒后迟发性脑病患者的脑白质和灰质区的微观结构病理损害程度,DEACMP患者脑白质所测平均ADC值与FA值均低于对照组(P<0.05),灰质核团ADC值有所增高,特别是苍白球明显增高,FA明显降低(P<0.01)。结论一氧化碳中毒在不同脑白质区和不同灰质区核磁共振DTI扩散特征参数ADC值与FA值,对评价病情及预测DEACMP的发生具有临床价值。

Objective To investigate the correlation between the values of ADC and FA the specific diffusion parameters of nuclear magnetic resonance DTI in different cerebral white matters and gray regions during acute carbon monoxide poisoning, and delayed encephalopathy after the acute carbon monoxide poisoning （DEACMP）. Methods The values of ADC and FA in 30 patients with DEACMP and 35 patients without DEACMP were summarized and analyzed. Results According to the values of ADC and FA, monitor the degree of pathological damage in different cerebral white matter and gray regions. In cerebral white matters of patients with DEACMP, the average values of ADC and FA were lower than the control group （P 〈 0.05）. In cerebral gray matters, especially in the globus pallidus, the value of ADC were higher than the control group, but the value of the FA were lower significantly compared with the control group （P 〈 0.01）. Conclusion The values of ADC and FA in different cerebral white matters and different gray regions are meaningful to evaluate disease and predict the DEACMP.