脑卒中创伤后应激障碍中磁共振影像学诊断的应用

Application of Magnetic Resonance Imaging in the Diagnosis of Post Traumatic Stress Disorder in Stroke

目的:以磁共振成像(MRI)T2加权像(T2WI)的海马和杏仁核影像学为依据,探讨其在脑卒中创伤后应激障碍中的诊断应用。方法:选择2021年1月~2023年1月本院接诊的66例脑卒中患者为研究对象,统计患者的临床资料、量表评分、MRI影像信息。结合海马、杏仁核最大层面的T2WI图像特征,提取对应的纹理特征参数,应用LASSO回归降维并构建诊断脑卒中后创伤后应激障碍(PTSD)与非PTSD的海马和杏仁核影像组学模型。结果:脑卒中后PTSD和非PTSD患者在人口学、临床特征方面无显著差异(P>0.05);脑卒中后PTSD患者在改良年龄相关白质改变量表评分、PTSD症状清单平民版评分大于非PTSD患者(P<0.05)。借助LASSO回归有效筛选出9个海马、14个杏仁核纹理特征参数,并构建诊断脑卒中后PTSD和非PTSD的影像学模型。结论:应用海马和杏仁核T2WI影像学模型来诊断脑卒中后PTSD患者时具备较高效能,临床可通过应用磁共振影像学来加强对脑卒中后PTSD的诊断及评估。

Objective:To explore the diagnostic application of magnetic resonance imaging(MRI)T2 weighted imaging(T2WI)in the diagnosis of post traumatic stress disorder in stroke based on the imaging of the hippocampus and amygdala.Methods:A total of 66 stroke patients admitted from January 2021 to January 2023 were selected as the study subjects,and their clinical data,scale scores,and MRI image information were statistically analyzed.Combining the T2WI image features of the largest layers of the hippocampus and amygdala,extracting corresponding texture feature parameters,applying LASSO regression to dimensionality reduction,and constructing an imageomic model of the hippocampus and amygdala for diagnosing PTSD and non PTSD after stroke.Results:There was no significant difference in demographic and clinical characteristics between PTSD and non PTSD patients after stroke(P>0.05);The scores of PTSD patients after stroke on the modified age related white matter change scale and the civilian version of the PTSD symptom list were higher than those of non PTSD patients(P<0.05).Using LASSO regression,9 hippocampal and 14 amygdala texture feature parameters were effectively screened,and imaging models for diagnosing post stroke PTSD and non PTSD were constructed.Conclusion:T2WI imaging models of the hippocampus and amygdala are highly effective in the diagnosis of PTSD after stroke.The clinical application of magnetic resonance imaging can enhance the diagnosis and evaluation of PTSD after stroke.