磁共振弥散张量成像对预测针刺治疗偏头痛疗效的价值研究

Value of diffusion tensor-magnetic resonance imaging in predicting the efficacy of acupuncture for migraine

目的探讨磁共振弥散张量成像(diffusion tensor-magnetic resonance imaging,DT-MRI)对预测针刺治疗偏头痛临床疗效的价值。方法选取偏头痛患者116例作为观察组,另选取健康人50例作为对照组。观察组予针刺治疗,对照组不做任何干预。采用DT-MRI检查两组胼胝体,比较两组胼胝体各部分的各向异性分数(fractional anisotropy,FA)和表观扩散系数(apparent diffusion coefficient,ADC)值,比较观察组中有效病例和无效病例的胼胝体各部分的FA和ADC值,分析胼胝体各部分FA值对预测针刺疗效的价值。结果观察组胼胝体膝部、体部和压部的FA值明显低于对照组(P<0.05)。两组胼胝体膝部、体部和压部的ADC值比较,差异无统计学意义(P<0.05)。观察组治疗有效的患者为89例,无效27例;有效患者胼胝体膝部、体部和压部的FA值明显高于无效患者(P<0.05);有效和无效患者胼胝体膝部、体部和压部的ADC值比较,差异无统计学意义(P>0.05)。胼胝体膝部、体部和压部的FA值对预测针刺治疗偏头痛疗效的ROC曲线下面积分别为0.793、0.949和0.729,差异均具有统计学意义(P<0.05);且胼胝体体部的FA值预测价值最高。结论磁共振弥散张量成像检测偏头痛患者胼胝体膝部、体部和压部的FA值可作为预测针刺治疗偏头痛临床疗效的依据。

Objective To explore the value of diffusion tension-magnetic resonance imaging(DT-MRI)in predicting the clinical efficacy of acupuncture for migraine.Method A total of 116 migraine patients were selected as an observation group,and 50 healthy people were selected as a control group.The observation group was treated with acupuncture,and the control group did not receive any intervention.The fractional anisotropy(FA)and apparent diffusion coefficient(ADC)of each part of the corpus callosum were compared between the two groups.The FA and ADC values of each part of the corpus callosum in the effective cases and ineffective cases in the observation group were compared,and the value of FA values of each part of the corpus callosum in predicting the efficacy of acupuncture was analyzed.Result The FA values of genu,body and splenium of corpus callosum in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in ADC values of genu,body and splenium of corpus callosum between the two groups(P<0.05).In the observation group,89 patients were effective and 27 patients were ineffective.The FA values of genu,body and splenium of corpus callosum in effective patients were significantly higher than those in ineffective patients(P<0.05).There was no significant difference in ADC values of genu,body and splenium of corpus callosum between effective and ineffective patients(P>0.05).The area under the ROC curve of FA values of genu,body and splenium of corpus callosum in predicting the efficacy of acupuncture for migraine was 0.793,0.949 and 0.729,respectively,and the differences were statistically significant(P<0.05).The FA value of corpus callosum had the highest predictive value.Conclusion The FA values of genu,body and splenium of corpus callosum detected by DT-MRI can be used to predict the clinical efficacy of acupuncture for migraine.