抽动秽语综合征患者双侧基底节结构体积的MR测量

MR measurement of the basal ganglia volume in the Tourette syndrome

目的 对比研究抽动秽语综合征（TS）患者与健康志愿者基底节结构的体积,初步探讨TS发病的可能病理解剖基础.方法 搜集TS患者（TS组）和健康志愿者（对照组）各31例,行3.0TMR三维梯度回波（3D SPGR）扫描,测量双侧壳核、苍白球、尾状核的体积,并根据颅内容积的大小对测得的体积进行标准化处理,采用t检验对2组数据进行比较分析.结果 TS组左、右侧尾状核、苍白球、壳核的体积分别为（4.11 ±0.12）和（3.76±0.11）、（2.28±0.12）和（2.35±0.28）、（4.98±0.20）和（4.89 ±0.31）cm^3,对照组分别为（4.88±0.19）和（4.30±0.12）、（2.79±0.22）和（2.72±0.19）、（5.10±0.39）和（5.07 ±0.17）cm^3.TS组左、右侧尾状核、苍白球的体积均小于对照组,差异有统计学意义（t值分别为2.97、1.74、3.72和3.93,P值均＜0.05）；左、右侧壳核的体积2组间差异无统计学意义（t值分别为0.47和1.31,P值均＞0.05）.TS组双侧尾状核的体积差异无统计学意义（t=1.81,P＞0.05）；对照组左侧尾状核的体积大于右侧,差异有统计学意义（t=2.34,P＜0.05）；2组双侧苍白球、壳核的体积差异均无统计学意义（t值分别为1.12、1.44、1.68、0.38,P值均＞0.05）.结论 基底节结构的体积异常可能是TS病理解剖基础。

Objective To compare the volume of the basal ganglia in patients with Tourette syndrome（T S） and the normal volunteers and to explore the underlying anatomical basis of TS.Methods Thirty-one cases of TS （TS subjects）,31 gender and age-matched subjects （the control subjects） were examined on a 3.0 T MRI system.The volume of the caudate nucleus,globus pallidus,putamen of the two sides and the brain volume were measured with volume analysis software,and the data were normalized according to the individual brain volume.Statistical analysis was performed using t test to compare between the TS subjects and the controls.Results The volume of the both sides of the caudate nucleus,putamen and globus pallidus of TS subjects were （4.11±0.12） and （3.76 ±0.11）,（2.28±0.12）and（2.35±0.28）,（4.98 ±0.20） and （4.89 ±0.31）cm3,while they were （4.88 ±0.19） and （4.30 ±0.12）,（2.28±0.12）and （2.35 ± 0.28）,（4.98 ± 0.20） and （4.89 ± 0.31） cm^3 in the controls,respectively.There were significant differences in the bilateral caudate nucleus and globus pallidus between the TS subjects and control subjects （t =2.97,1.74,3.72,3.93,P 〈 0.05）,but there were no significant differences of the volume in the bilateral putamen between the TS and control subjects（t =0.47,1.31,P 〉0.05）.The volume was not significantly different between the left and right caudate nucleus in the TS subjects （t =1.81,P 〉0.05）,but the left volume of the caudate nucleus was bigger in the control subjects compared with the right volume,however,there was significant difference between the bilateral caudate nucleus in the control subjects （t =2.34,P 〈 0.05）.There were no differences of volume between the bilateral globus pallidus and putamen in both the TS and control subjects （t =1.12,1.44,1.68,0.38,P 〉 0.05）.Conclusion The abnormal volume of caudate nucleus,putamen,and the globus pallidus may be involved in the pathogenesis of TS.