基于TBSS方法的轻度颅脑损伤患者脑网络的纤维束成像研究

White matter fibers imaging of patients with mild brain injury based on tract based spatial statistics

目的应用功能磁共振弥散张量成像（DTI）技术观察轻度颅脑损伤患者大脑白质纤维网络细微结构的损伤并探讨其改变的意义。方法轻度颅脑损伤组患者来自安徽医科大学附属省立医院神经外科门诊自2015年4月至2015年9月接诊的18例轻度颅脑损伤患者。健康对照组来自同期招募的性别、年龄、教育程度与轻度颅脑损伤组患者均匹配的18名健康人。2组受试者均接受MRJ扫描，获得DTI数据，利用基于纤维束示踪的空间统计（TBSS）方法计算脑白质纤维束的部分各向异性ffA）值并构建纤维束网络骨架，探讨轻度颅脑损伤患者大脑白质纤维束的损伤区域。结果与健康对照组比较，轻度颅脑损伤组患者脑白质纤维束的胼胝体膝部和体部、双侧前放射冠、左侧丘脑后辐射（包括视辐射束）和右侧外囊等区域FA值降低，差异有统计学意义（P〈0．05）；未发现FA值增高的区域。结论TBSS方法发现轻度颅脑损伤患者大脑白质纤维束的细微结构异常，可能与脑震荡综合征的临床表现有关。

Objective To find the microstructural damage of white matter fiber network in patients with mild traumatic brain injury using diffusion tensor magnetic resonance imaging （DTI） and discuss the clinical significance of these changes. Methods Eighteen patients with mild brain injury, received treatment in our hospital from April 2015 and September 2015, were included as patient group, while 18 gender-, age- and education degree-matched healthy subjects were used as control group; they all accepted magnetic resonance scanning during 3 or 4 weeks after injury; the DTI data were obtained, the fractional anisotropy （FA） values were calculated and white matter fibers network was built with the method of tract-based spatial statistics （TBSS）; the changes of microstructure damage were investigated and the clinical significance of the changes were analyzed. Results Significantly lower FA values were found in areas including the genu of corpus callosum, body of corpus callosum, anterior corona radiata, left posterior thalamic radiations（including optic radiation） and right external capsule in patient group as compared with those in control group （P〈0.05）. No increased FA value areas were noted. Conclusion The microstructural damage of white matter fibers is found in patients with mild traumatic brain injury, which may be a link with clinical syndrome after concussion.