视网膜脱离患者脑白质纤维束的异常变化

Abnormal changes in cerebral white matter fiber bundle in patients with retinal detachment

目的利用弥散张量成像数据探讨视网膜脱离(RD)患者脑白质纤维束的异常变化和该疾病潜在的病理生理机制。方法选取南昌大学第一附属医院眼科收治的RD患者30例(男16例,女14例)作为观察组,另招募30名健康人(男16人,女14人)作为对照组。所有受试者的功能性磁共振成像(MRI)数据均由八通道相控阵头线圈3-Tesla MRI扫描仪采集获得,使用FMRIB软件库对MRI数据进行预处理,对预处理后的数据进行基于纤维束示踪的空间统计分析,利用v3.0FMRIB工具箱依据原始数据重建张量矩阵,计算扩散指标各向异性分数,对有意义的病变区域各向异性分数进行统计学分析。结果两组受试者年龄、体质量比较,差异均无统计学意义(均为P>0.05);对照组左眼及右眼的最佳矫正视力均优于观察组,差异均有统计学意义(均为P<0.001)。与对照组相比,观察组患者位于下额枕束1(右侧)、胼胝体辐射额部、下额枕束2(右侧)、放射冠前部(左侧)、上纵束(右侧)、胼胝体辐射枕部、扣带(右侧)、丘脑前辐射(右侧)的纤维束的各向异性分数显著升高,差异均有统计学意义(均为P<0.01)。结论RD患者部分纤维束各向异性分数异常与视功能改变相关。

Objective To investigate the abnormal changes in white matter fiber tracts in patients with retinal detachment(RD)and the underlying pathophysiological mechanism of the disease through diffusion tensor imaging(DTI)data.Methods Thirty RD patients(16 males and 14 females)admitted in the Department of Ophthalmology of the First Affiliated Hospital of Nanchang University were selected as the observation group,and another 30 healthy individuals(16 males and 14 females)were recruited as the control group.The functional magnetic resonance imaging(MRI)data for all subjects were obtained from the eight-channel phased array head coil 3 Tesla MRI scanner.FMRIB software library was used to preprocess the MRI data which were analyzed by spatial statistics based on fiber bundle tracing.The tensor matrix was reconstructed by using v3.0 FMRIB toolbox according to the original data,and the anisotropic ratio of diffusion index was calculated.The anisotropic ratio of significant lesion area was analyzed statistically.Results There were no significant differences in age and body mass between the two groups(both P>0.05).The best corrected visions of the left and right eyes in the control group were better than those of the observation group,and the differences were statistically significant(both P<0.001).Compared with the control group,these data,including anisotropic ratio of the inferior fasciculus frontooccipitalis 1(right),pars frontalis radiationis corporis callosi,inferior fasciculus frontooccipitalis 2(right),the anterior corona radiata(left),superior longitudinal fasciculus(right),occipital radiation of corpus callosum and cingulate areas(right),were all increased significantly(all P<0.01).Conclusion The abnormal ratio of fiber bundle anisotropy in RD patients is related to the changes in visual function.