基于纤维束示踪的空间统计分析在帕金森病扩散张量成像中的应用研究

Diffusion Tenser Imaging Study of Parkinson's Disease:TBSS Application

目的通过磁共振扩散张量成像(DTI)的基于纤维束示踪的空间统计分析(TBSS)技术研究帕金森病(PD)脑白质微结构的损害。方法 PD患者31例和健康对照组34名行磁共振检查,扫描序列包括常规磁共振平扫和DTI,通过TBSS技术比较PD组与对照组白质纤维束的各向异性分数(FA)值,寻找FA值有显著性差异的脑白质纤维束,并分析PD组白质纤维束损伤与MoCA、MMSE、HAMD、ADL和UPDRSIII评分的相关性。结果 PD组有多个纤维束FA值明显低于健康对照组,主要包括胼胝体、上纵束、扣带束、视辐射、额叶及颞叶皮层下弓形纤维、脑干及内囊的白质束。其中胼胝体压部、左上纵束、右上纵束、小脑中脚FA值与MMSE评分呈正相关;右上纵束、左皮质脊髓束、左小脑上脚、右皮质脊髓束和小脑中脚FA值与HAMD评分呈负相关;胼胝体压部、左上纵束、右上纵束FA值与ADL评分呈负相关。结论磁共振DTI的TBSS技术能够发现PD患者白质微结构的损害及其与认知和抑郁之间的关系,有助于研究PD患者认知功能障碍和抑郁的发生机制。

Objective To evaluate the microstructure of white matter damage of Parkinson＇s disease by TBSS of MR diffusion tensor imaging. Methods Both 31 patients with Parkinson＇s disease and 34 healthy subjects were scanned with conventional MRI and DTI examination. Then Compared PD group and control group of white matter tracts of FA value by TBSS,later checked whether FA values are significantly different in the white matter tracts and then analyzed the correlation between white matter fiber tract injury and MoCA,MMSE,HAMD,ADL and UPDRSIII score. Results The FA values of the fiber bundles including corpus callosum,superior longitudinal fasciculus,cingulate gyrus,optic radiation,frontal lobe and temporal lobe subcortex arcuate fiber,brain stem and white matter of the internal capsule bundles in PD group were significantly lower than those in the healthy control group. The FA values of the corpus callosum,left and right superior longitudinal fasciculus,cerebellar peduncle were positively correlated with MMSE scores,the FA values of right superior longitudinal fasciculus,left corticospinal tract,left cerebellar peduncle,right corticospinal tract,cerebellar peduncle were negatively correlated with HAMD scores,the FA values of splenium of corpus callosum,left superior longitudinal fasciculus,right superior longitudinal fasciculus,were negatively correlated with the ADL scores. Conclusion TBSS of MR diffusion tensor imaging could discover the relationship between the damage of white matter microstructure in Parkinson＇s disease and cognitive depression. It helps to study Parkinson＇s disease pathogenesis of cognitive dysfunction and depression.