抑郁症首次发病患者静息态脑灌注的动脉自旋标记成像初步观察

The preliminary study of resting state cerebral perfusion on first-onset depressive disorder with magnetic resonance imaging arterial spin-labeling imaging

目的比较首次发病抑郁症患者与健康对照者是否存在脑血流灌注异常的脑区，并探讨研究结果的准确性。方法采用伪连续式动脉自旋标记成像技术对10例首次发病抑郁症患者（患者组）及15名健康志愿者（对照组）进行全脑磁共振扫描，采用SPM及REST软件对2组图像进行预处理及统计学分析，对2组进行全脑水平的血流灌注分析。结果患者组与对照组比较，左颞叶（t=-6．7440）、左额叶及扣带回（t=-7．6494）、左中央旁小叶及中央前回（t=-8．2019）、右中央后回（t=-6．8639）血流灌注明显减低（P〈0．05，簇≥30，经FDR校正）；右小脑后叶及扁桃体（t=4．6746，t=5．8710）、右丘脑（t=7．9571）、右额叶及前扣带回（t=6．8155）、右前扣带回（t=7．0385）等脑区的血流灌注增加（P〈0．05，簇≥30，经FDR校正）。结论抑郁症患者既存在血流灌注减低的脑区，也存在血流灌注增加的脑区，以左侧半球灌注减低为主，与以往大部分研究结果较一致。动脉自旋标记成像技术可应用于抑郁症脑血流灌注方面的研究。

Objective To research whether the cerebral perfusion is abnormal in first-onset depressive disorder compared to the volunteers and discuss the accuracy of the result. Methods Ten firstonset depressive disorder patients and 15 healthy volunteers were scanned with 3.0 T MRI by pseudo- continuous arterial spin-labeling imaging. Using SPM and REST software to complete the image preproeessing and statistical analysis of the two groups and analyze their cerebral perfusion level of the whole brain. Results Compared with the volunteers, the cerebral perfusion of the left temporal lobe （t=-6.744 0）, left frontal and cingulate gyrus （t=-7.649 4）, left paracentral lobule and precentral gyrus （t=-8.201 9）, right posterior central gyrus （t=-6.863 9） in depressive disorder patients was reduced （P〈 0.05, cluster size≥30, FDR correction）. The cerebral perfusion of the right cerebellum （t=4.674 6, t=5.871 0）, right hypothalamus （t=7.957 1）, right frontal lobe and anterior cingulate gyrus （t=6.815 5）, right anterior cingulate gyrus （t=7.038 5） in depressive disorder patients was increased （P〈0.05, cluster size≥30, FDR correction）. Conclusions Depressive disorder patients both have reduced areas of cerebral perfusion and increased areas of cerebral perfusion, and cerebral perfusion reduction in the left hemisphere may be the main trend. It is applicable for the arterial spin-labeling imaging to research the cerebral perfusion of the depressive disorder patients.