多模态MRI在精神分裂症诊断中的应用价值研究

Explore the Value of Multimodal MRI in the Diagnosis of Patients with Schizophrenia

目的探讨多模态MRI诊断精神分裂症(SZ)患者的临床价值。方法选取2018年1月至2020年1月我院收治的首发SZ患者112例为SZ组,同期健康体检者62例为对照组,均行三维MRI图像扫描,进行基于体素形态学研究(VBM)的脑非对称性分析,比较两组脑灰质体积、密度及脑区面积。结果SZ组患者出现颞中回、额上回、眶回、尾状核头、丘脑的正常左侧>右侧的非对称性降低,颞上回的正常右侧>左侧的非对称性降低,海马、海马旁回的正常右侧>左侧的非对称性增大,扣带回部分区域的非对称性消失,中央后回呈左侧>右侧的灰质密度非对称性反转;SZ组双侧尾状核头、左侧小脑前后叶、双侧丘脑的脑灰质密度及脑区面积均显著低于对照组,差异有统计学意义(P<0.05);SZ患者脑灰质体积较对照组降低。结论SZ患者存在脑结构非对称性紊乱,脑灰质体积、密度较正常人降低,多模态MRI可作为诊断SZ的辅助性手段。

Objective To explore the clinical value of multimodal MRI in the diagnosis of patients with schizophrenia(SZ).Methods 112 patients with first-episode SZ in our hospital from January 2018 to January 2020 were selected in SZ group,and 62 healthy examiners at the same period were set as control group.All patients underwent three-dimensional MRI scan,and given brain asymmetry analysis based on voxel-based morphometry(VBM).The brain gray matter volume,density and brain area were compared between the two groups.Results In SZ group,the asymmetry of normal left side over right side in the middle temporal gyrus,superior frontal gyrus,gyri orbitales,caput nuclei caudati and thalamus was reduced,and the asymmetry of normal right side over left side in superior temporal gyrus was reduced,and the asymmetry of hippocampus and parahippocampal gyrus were increased,and the asymmetry of partial area of cingulate gyrus was disappeared,and the asymmetry of gray matter density of left side over right side in posterior central gyrus was reversed.The brain gray matter density and brain area of bilateral caudate nucleus,left anterior and posterior lobes of cerebellum and bilateral thalamus in SZ group were significantly lower than those in control group(P<0.05).The brain gray matter volume of SZ patients was reduced compared with that in control group.Conclusion There is a brain structural asymmetry disorder in SZ patients.The volume and density of gray matter are lower than normal people.Multimodal MRI can be used as an auxiliary means to diagnose SZ.