Duchenne型肌营养不良症扩散张量成像研究

A study of diffusion tensor imaging in Duchenne muscular dystrophy

目的通过扩散张量成像(DTI)观察Duchenne型肌营养不良症患儿脑结构和功能改变。方法共14例Duchenne型肌营养不良症患儿均行DTI检查,以双侧顶叶白质、额叶白质、胼胝体膝部和压部、尾状核头、扣带前回、扣带中回、扣带后回、豆状核、内囊前肢和后肢、丘脑、枕叶白质、颞叶白质、海马、小脑上脚和小脑中脚等脑区为兴趣区,测定各兴趣区部分各向异性(FA)值。结果与正常对照者相比,Duchenne型肌营养不良症患儿仅胼胝体压部FA值降低(t=-2.187,P=0.045),其余脑区FA值组间差异均无统计学意义(P>0.05)。结论 Duchenne型肌营养不良症患儿胼胝体压部存在微细结构改变,然而,其与Duchenne型肌营养不良症患儿认知功能改变之间的相关性尚待进一步研究。

ObjectiveTo observe the white matter and gray matter impairment of Duchennemuscular dstrophy（DMD） patients with diffusion tensor imaging（DTI）.MethodsForteen male patientswith DMD（6-11 years old） and 10 age-matched healthy boys participated into this study. All patients＇ diagnosis was based on typical signs and symptoms, serum creatine kinase（CK）, electromyography,multiplex ligation-dependent probe amplification（MLPA） for DMD gene test and muscle biopsy results. Allparticipants were scanned by DTI. The fractional anisotropy（FA） values of regions of interest（ROIs）,including bilateral parietal lobe white matter, bilateral frontal lobe white matter, genu of corpus callosum,splenium of corpus callosum, bilateral caput nuclei caudati, bilateral anterior cingulate gyrus, bilateralcingulate gyrus, bilateral posterior cingulate gyrus, bilateral lenticular nucleus, bilateral anterior limb ofinternal capsule, bilateral posterior limb of internal capsule, bilateral thalamus, bilateral occipital lobe whitematter, bilateral temporal lobe white matter, bilateral hippocampus, bilateral superior cerebellar peduncleand bilateral middle cerebellar peduncle, were measured. The data was analyzed and compared betweencontrol group and DMD group.ResultsCompared with control group, the FA value of splenium of corpuscallosum in DMD group was significantly reduced（t =- 2.187, P = 0.045）. No significant difference wasfound in FA values of other ROIs between 2 groups（P 0.05, for all）.ConclusionsIt is found in Chinafor the first time that DMD patients had microstructural changes in splenium of corpus callosum. However,the correlation between this change and cognitive changes of DMD patients remains to be further studied.