系统性红斑狼疮颅内微结构的扩散峰度成像研究

Research on brain microstructural changes in systemic lupus erythematosus patients using MR diffusion kurtosis imaging

目的:利用磁共振扩散峰度成像(DKI)技术评估神经精神狼疮患者(NPSLE)及无神经精神症状的系统性红斑狼疮患者(non-NPSLE)颅内微结构的改变,探讨fMRI参数与认知功能的关系。方法:采用3.0T MR仪对22例NPSLE患者、21例non-NPSLE患者及20例年龄及性别与两组患者相匹配的健康志愿者(HC)行MR DKI扫描。应用Functool软件对DKI数据进行后处理,测量双侧背侧丘脑(DT)、扣带回后部(PCG)、豆状核(LN)及侧脑室后角旁白质(PWM)的平均峰度值(MK)。同期采用简易智能评定量表(MMSE)、(北京版)蒙特利尔认知评估量表(MoCA)对所有研究对象的认知功能进行评估。采用协方差分析比较3组间各部位MK值的差异,采用Spearman秩相关法对MK值与认知功能评分的相关性进行分析。结果:与HC组比较,NPSLE组和non-NPSLE组在双侧PCG及左侧DT的MK值明显降低(P<0.01),两组患者间的MK值在各感兴趣区均无统计学差异(P>0.05)。三组研究对象双侧PCG的MK值与MoCA评分呈正相关(右侧PCG:rs=0.291,P=0.046;左侧PCG:rs=0.364,P=0.017)。结论:DKI技术有利于评估SLE患者颅内微结构的损伤,SLE患者认知功能的减低与扣带回后部微结构的异常改变有关。

Objective:This study aim to assess the change of brain microstructural in systemic lupus erythematosus(SLE)patients with and without neuropsychiatric symptoms using magnetic resonance(MR)-diffusion kurtosis imaging(DKI).Methods:MR-DKI examination was performed in 22 NPSLE patients,21 non-NPSLE patients and 20 healthy controls(HCs).The mean kurtosis(MK)was measured bilaterally in the posterior cingulate gyrus(PCG),dorsal thalamus(DT),lentiform nucleus and posterior paratrigonal white matter.The MMSE and MoCA were applied to evaluate cognitive function of all participants.We compared MK among three groups using Analysis of Covariance.The relationships between MK and cognitive functionscores were analyzed by Spearman rank correlation.Results:The NPSLE and non-NPSLE patients had lower MK values in bilateral PCG and left DT compared with HCs(P<0.01).However,(P>0.05).Positive correlations were found between MoCA scores and MK values in the bilateral PCG(right PCG:rs=0.291,P=0.046;left PCG:rs=0.364,P=0.017).Conclusion:Diffusion kurtosis imaging is useful for evaluating SLE subjects brain microstructural.Impairments of cognitive function in SLE patients may be interpreted by microstructural changes in the PCG.