单相抑郁症患者前扣带回联合磁共振张量成像及波谱成像的临床研究

Clinical application of the combination of MR DTI and MRSI on anterior cingulate cortex of patients with unipolar depression

目的:研究前扣带回磁共振弥散张量成像(DTI)及磁共振波谱(MRS)成像技术联合运用在单相抑郁症诊断中的临床价值。方法:选取在医院就诊的30例单相抑郁症患者,并将其纳入单相抑郁症组,另选30名体检者纳入健康对照组。两组受检者均行脑部常规磁共振成像(MRI)、DTI序列和MRS序列扫描,扫描范围为受试者前扣带回,分别测量感兴趣区域(ROI)的各向异性分数(FA)值及N-乙酰天门冬氨酸(NAA)与肌酸(Cr)比值(NAA/Cr);胆碱(Cho)与Cr比值(Cho/Cr),并进行统计学分析。结果:健康对照组左、右侧前扣带回FA值分别为(0.440±0.023)和(0.431±0.023),单相抑郁症组左、右侧前扣带回FA值为(0.430±0.018)和(0.421±0.016),两组比较差异具有统计学意义(t=-2.256,t=-2.062;P<0.05)。健康对照组与单相抑郁症组患者双侧前扣带回NAA/Cr分别为左侧(1.607±0.051)和(1.581±0.034),右侧(1.611±0.044)和(1.592±0.036),左侧前扣带回Cho/Cr为(1.319±0.022)和(1.303±0.032),两组比较差异具有统计学意义(t=-2.632,t=-2.239,t=-2.353;P<0.05)。结论:前扣带回DTI及MRS联合成像技术能同时反映单相抑郁症患者前扣带回微结构变化及病程中前扣带回代谢异常,在单相抑郁症患者MRI评估中有一定的临床应用价值。

Objective:To explore the clinical value of the combination of magnetic resonance diffusion tensor imaging(MR DTI)and magnetic resonance spectroscopy imaging(MRSI)in the diagnosis on anterior cingulate cortex of patients with unipolar depression.Methods:30 patients with unipolar depression who admitted in hospital were divided into unipolar depression group and 30 normal subjects who were health in the results of physical examination were divided into healthy control group.All of them underwent routine MRI,DTI sequence and MRS sequence on their brains.And the scope of scan was anterior cingulate cortex of receivers.The fractional anisotropy(FA)of the region of interest(ROI),the ratios of N-acetylasparte and Creatine(NAA/Cr),and the ratios of Choline and Creatine(Cho/Cr)were measured and were further analyzed as statistic method.Results:The FA values of anterior cingulate cortex of left and right sides in healthy control group were(0.440±0.023)and(0.431±0.023),and those of anterior cingulate cortex of left and right sides in unipolar depression group were(0.430±0.018)and(0.421±0.016),respectively,and the differences of them between two groups were statistically significant(t=-2.256,t=-2.062,P<0.05).The NAA/Cr of bilateral anterior cingulate cortex of healthy control group and unipolar depression group were(1.607±0.051)and(1.581±0.034)on the left side,and were(1.611±0.044)and(1.592±0.036)on the right side,respectively.And the ratios of Cho/Cr of anterior cingulate cortex of left side of two groups were(1.319±0.022)and(1.303±0.032),respectively.The differences of those between two groups were statistically significant(t=-2.632,t=-2.239,t=-2.353,P<0.05).Conclusion:The combined imaging technique of DTI and MRS on anterior cingulate cortex can simultaneously reflect the microstructural changes of anterior cingulate cortex and abnormal metabolism of anterior cingulate cortex during the course of disease in patients with unipolar depression.It has certain clinical value in the MRI assessment for patients with unipolar depression.