精神分裂症患者透明隔间腔的MRI形态学研究

Morphological study of the cavum septum pellucidum in schizophrenia patients based on magnetic resonance imaging

目的:探讨精神分裂症(SZ)患者及健康人群中透明隔间腔(CSP)的出现率及其形态学特点。方法:109例SZ患者和人口学特征匹配的109例健康受试者(对照组)行头颅MRI扫描,采用三维磁化准备快速梯度回波(MPRAGE)序列获取T1结构像,使用MRIcroN分析软件对图像进行处理。对CSP的最大长度(前后径)进行测量并比较两组间的差异,对2组中大CSP(最大长度≥6mm)和小CSP(最大长度<6mm)的出现率进行比较。结果:SZ组和健康对照组中CSP的出现率分别为60.3%和40.3%,差异有统计学意义(P<0.05)。SZ组中大CSP的出现率高于健康对照组(分别为11.9%和2.0%,P<0.05),但两组中小CSP出现率(的差异无统计学意义(分别为34.6%和38.5%,P>0.05)。有CSP的SZ患者中CSP的长度与患者的症状量表(PANSS)评分间无显著相关性。结论:精神分裂症患者中小CSP的出现率与健康人群间无明显差异,但大CSP的出现率高于健康人群,可能是SZ患者边缘系统神经环路发育异常的一种表现,这种异常可被看作是精神分裂症神经发育病因学假说的依据。

Objective： To explore prevalence rate and morphological features of cavum septum pellucidum （CSP） in schizophrenia （SZ） patients and healthy controls. Methods： One hundred and nine schizophrenia patients and 109 demo graphically matched healthy controls underwent cerebral magnetic resonance imaging examination. T1-weighted structural images were obtained with three dimensional magnetization prepared rapid gradient echo sequence （MPRAGE） and were post-processed using MRIcroN software. The maximum length of CSP was measured and the difference between the two groups was compared. Prevalence rate of CSP, small CSP （maximum length 〈6mm）, and large CSP （maximum length ≥6mm） in SZ group and control group was calculated and then compared. Clinical symptoms of SZ patients were evaluated with Positive and Negative Syndrome Scale （PANSS）. Results： Significant difference was found in the prevalence rate of CSP （60.30/oo in SZ group and 40.3% in control group,P〈0.05）. The prevalence rate of large CSP in SZ group was higher than that in control group （11.9% vs 2.0% ,P〈0.05）. However,there was no significant difference in the prevalence rate of small CSP between the two groups （P〉0.05）. There was no correlation between the length of CSP and PANSS score. Con- clusion：The small CSP in SZ patients may be a normal variant compared with healthy controls. The prevalence rate of large CSP in SZ patients is higher than that in healthy controls,it probably reflects aberrant neurodevelopment of the limbic sys- tem in SZ patients,and may be considered as the evidence to support neurodevelopmental hypothesis of SZ.