扩散峰度成像在小儿结节性硬化症中的应用

Application of diffusion kurtosis imaging in children with tuberous sclerosis complex

目的:探讨扩散峰度成像(DKI)对小儿结节性硬化症(TSC)的诊断价值。方法:对32例在本院经临床诊断为TSC的患儿行脑部DKI检查(b值为0、1000和2000s/mm^2,各有15个扩散方向),测量患儿67个灰质结节及45个白质病变的平均扩散峰度(MK)、轴向峰度(AK)及径向峰度(RK)值,并与对侧正常区域进行对照分析。结果:灰质结节和对侧正常灰质的MK、AK及RK值分别为0.57±0.14、0.47±0.09、0.62±0.12和0.72±0.11、0.49±0.07、0.76±0.13;灰质结节的MK、RK值显著低于正常灰质,差异均有统计学意义(P<0.01),而AK值的差异无统计学意义(P>0.05)。白质病变和对侧正常白质的MK、AK及RK值分别为0.63±0.16、0.54±0.09、0.66±0.14和0.78±0.11、0.60±0.11、0.86±0.12;白质病变的MK、RK值较对侧显著下降(P<0.001),而AK值与对侧比较差异无统计学意义(P>0.05)。结论:DKI测量参数可反映TSC患者脑组织内细胞结构的变化,可为研究TSC的微观病理改变提供依据。

Objective:To investigate the diagnostic value of diffusion kurtosis imaging(DKI)in pediatric patients with tuberous sclerosis complex(TSC).Methods:Thirty-two children with clinical diagnosis of tuberous sclerosis were enrolled in this study.DKI imaging of the brain(b values of 0,1000 and 2000s/mm 2,each with 15 diffusion directions).The mean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)of grey matter tubers(n=67)and white matter lesions(n=45)were measured and compared with the contralateral normal area.Results:The MK,AK and RK values of gray matter tubes and contralateral normal gray matter were 0.57±0.14,0.47±0.09,0.62±0.12 and 0.72±0.11,0.49±0.07,0.76±0.13 respectively;The MK,AK and RK values of the white matter lesions and contralateral normal white matter were 0.63±0.16,0.54±0.09,0.66±0.14 and 0.78±0.11,0.60±0.11,0.86±0.12,respectively.The MK and RK values of tubers were significantly lower than those of normal gray matter(all P<0.01),there was no significant difference in AK value.Compared with symmetric normal areas,the MK and RK values of white matter lesions decreased with significantly statistical difference(all P<0.001),while AK value was slightly decreased with no statistical difference(P>0.05).Conclusion:The change of DKI parameters can reveal the change of TSC cell structure and provide the basis for studying the microscopic pathological changes of TSC.