磁共振扩散张量成像对阻塞性睡眠呼吸暂停低通气综合征患者脑白质损害的评价

Evaluation of brain white matter lesion in patients with obstructive sleep apnea-hypopnea syndrom with magnetic resonance diffusion tensor imaging

目的运用磁共振扩散张量成像(DTI)序列扫描,并用基于体素的分析(VBA)方法对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者全脑不同脑区的脑白质神经纤维束的完整性进行检测,探讨DTI对OSAHS患者脑白质损害的评价。方法收集OSAHS患者26例,以及与OSAHS组年龄、性别相匹配的正常志愿者22例,两组均为男性,行头颅DTI扫描。用DTI Studio软件和基于Matlab平台的SPM8和REST软件对所采集的图像进行后处理,并通过VBA方法分析。观察OSAHS组各向异性分数(FA)值相对于正常对照组的变化,得出两组差异有统计学意义的脑区位置以及簇体积。结果与对照组相比较,OSAHS组部分脑区FA值显著减低(P<0.001并经过alphasim校正),FA值下降的区域主要位于额叶及顶叶皮质、前、后扣带回、脑干、腹外侧核、胼胝体、背侧丘脑及杏仁核等。结论 OSAHS患者多个脑区FA值均较正常志愿者明显减低,证实OSAHS患者脑白质存在着广泛的损伤。运用VBA方法对DTI分析可以评价OSAHS患者的脑白质损伤。

Objective To detect the integrality of brain white matter fibers in different brain regions, and to discuss brain white matter lesion in patients with obstructive sleep apnea-hypopnea syndrome （ OSAHS） using diffusion tensor imaging （DTI） and voxel-based analysis （VBA） method.Methods Twenty-six male patients with OSAHS and twenty-two male healthy controls matched for age and gender, were included in this study.Two groups were performed conventional brain DTI scan.The DTI data were processed with the DTI studio, the software of REST and SPM8 on the Matlab.The date were analysed with VBA.Next, we can get the changes of fractional anisotmpy （FA） value in the OSAHS, compared to control subjects.And at last, it is concluded that the brain areas and cluster sizes with significant difference between the two groups.Results Compared with the control group, the brain area FA value of experimental group were significantly decreased, the FA values were significantly decreased in the front gyrus, parietal lobule, anterior cingulate, posterior cingulate, brainstem, ventral lateral nucleus, corpus callosum, amygdala and so on.Conclusion The FA values of multiple brain regions with OSAHS patients are significantly lower than those in normal volunteers, which confirmed that the white matter has a wide range of damage.The white matter microstructure can be qualitative analyzed using DTI based on the VBA method, which can evaluate brain white matter lesion in OSAHS patiens.