应用基于体素的形态测量学方法研究自发性正常压力脑积水

A voxel-based morphometry study on patients with idiopathic normal pressure hydrocephalus

目的研究自发性正常压力脑积水患者与正常人的颅脑结构形态学差异,探讨有助于iNPH影像学诊断的指标。方法应用3.0TMR对10例iNPH患者及12名年龄相仿正常人行常规头颅MR扫描及全脑3DT1WI扫描。使用基于体素的形态测量学方法分析iNPH患者CSF分布、白质及灰质体积的变化。结果 VBM分析发现,与正常人相比,iNPH患者侧脑室、3脑室、两侧侧裂池及鞍上池扩大,内囊体积增大,大脑纵裂旁以及额顶叶灰质体积增大;纵裂池及额顶叶脑沟变窄,胼胝体压部、双侧侧脑室旁白质及额顶叶深部白质体积减小,双侧颞叶灰质、尾状核、丘脑、海马体积缩小。结论 iNPH患者出现脑室系统、蛛网膜下腔的形态变化,除此之外尚存在其他颅脑结构改变,这些形态改变有助于iNPH的影像诊断。

Objective Objective To study the abnormalities of craniocerebral morphology in patient with idiopathic normal pressure hydrocephalus（iNPH）and explore helpful parameters for the diagnosis of iNPH.Methods Totally 10 patients with iNPH（iNPH group）and 12 healthy controls（control group）underwent routine head MR and three-dimensional T1 weighted imaging of whole brain.Voxel-based morphometry（VBM）was used to detect the volume change of cerebrospinal fluid,white matter and gray matter between the two groups.Results Compared to control group,the volume of lateral ventricle,third ventricle,lateral fissure,supra sellar cistern,internal capsule,para-interhemispheric and frontoparietal gray matter increased,while the volume of longitudinal cistern,frontal and parietal sulci,corpus callosum,periventricular white matter,deep white matter of frontal and parietal lobes,gray matter of temporal lobe,caudate nucleus,thalamus and the hippocampal decreased in iNPH group.Conclusion In addition to the volumetric change of CSF in the ventricular system and subarachnoid space,morphological changes of brain structure contribute to the diagnosis of iNPH.