DTI在评估抑郁症患者脑白质微结构改变的初步研究

Preliminary study of DTI in the evaluation of changes of white matter microstructure in patients with depression

目的研究弥散张量成像(DTI)评估抑郁症患者脑白质微结构改变的应用价值。方法选取2016年12月至2018年12月我院抑郁症患者47例为研究组及同期健康体检者50例为对照组,采用GE Singa HDxt 3.0T扫描仪和标准八通道头部线圈对全脑进行T1WI、T2WI、FLAIR及DTI等序列检查,将大脑白质分为50个感兴趣区域分别计算局部各向异性(FA)、平均扩散系数(MD)、轴向扩散系数(AD)及径向扩散系数(RD)等扩散张量参数并比较两组脑白质各项指标差异。结果研究组两侧皮质脊髓束AD、RD、MD及右侧下纵束-下额枕束AD、MD均高于对照组,差异有统计学意义(P<0.05);研究组两侧前扣带回、后扣带回及胼胝体体部FA值均低于对照组,右侧额上回、枕叶及内囊膝部FA值均低于对照组,差异有统计学意义(P<0.05)。结论DTI技术用于抑郁症患者脑白质微结构评估可定性、定量显示皮质脊髓束、下纵束-下额枕束、扣带回、枕叶、胼胝体及内囊等部位白质纤维束结构和功能破坏,为进一步明确抑郁发病机制提供影像学依据。

Objective To study the application value of diffusion tensor imaging(DTI)in the evaluation of changes of white matter microstructure in patients with depression.Methods A total of 47 patients with depression in our hospital from December 2016 to December 2018 were selected as study group,and 50 subjects with healthy physical examination at the same period were selected as control group.The GE Singa HDxt 3.0T scanner and standard eight-channel head coil were used to given sequences examinations of T1WI,T2WI,FLAIR and DTI in whole brain.White matter was divided into 50 regions of interest,and the diffusion tensor parameters of local anisotropy(FA),mean diffusion coefficient(MD),axial diffusion coefficient(AD)and radial diffusion coefficient(RD)were calculated,and the parameters in white matter were compared between the two groups.Results The AD,RD and MD of bilateral corticospinal tract and AD and MD of right inferior longitudinal fasciculus-inferior frontaloccipital fasciculus in study group were higher than those in control group(P<0.05).The FA values of bilateral anterior cingutate and posterior cingulate and the corpus callosum in study group were lower than those in control group,and the FA values of right superior frontal gyrus,occipital lobe and internal capsule were lower than those in control group(P<0.05).Conclusion DTI technique for the evaluation of white matter microstructure in patients with depression can qualitatively and quantitatively demonstrate the structure and functional damage of white matter fiber tracts in the corticospinal tract,inferior longitudinal fasciculus-inferior frontaloccipital fasciculus,cingulate gyrus,occipital lobe,corpus callosum and internal capsule,and provide imaging basis for further clarifying the pathogenesis of depression.