| 三维动脉自旋标记在重度OSAS患者脑白质灌注异常及认知功能障碍的研究 |
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| 引用本文： | 毛新峰,赵育英,姚丽娣,张惠美,沈健,陆华东.三维动脉自旋标记在重度OSAS患者脑白质灌注异常及认知功能障碍的研究[J].中华全科医学,2019,17(6):1004-1007. |
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| 作者姓名： | 毛新峰 赵育英 姚丽娣 张惠美 沈健 陆华东 |
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| 作者单位： | 1. 湖州市中心医院放射科, 浙江 湖州 313000; |
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| 基金项目： | 浙江省医药卫生科技计划项目(2014RCA029)；湖州市科技局公益项目(2015GY12) |
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| 摘 要： | 目的采用三维动脉自旋标记(3D-ASL)对重度阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者脑白质脑血流量(CBF)改变进行研究,并分析脑白质灌注异常与呼吸暂停低通气指数(AHI)、认知功能障碍之间的相关性。方法选取2014年12月—2016年12月在湖州市中心医院首次就诊经多导睡眠仪(PGS)监测确诊的重度OSAS患者(AHI>30次/h)56例为实验组;选取性别、年龄相匹配,无OSAS疾病的健康志愿者(AHI<5次/h)56例为健康对照组。采用GE Discovery 750 MR扫描仪分别对2组研究对象进行3D-ASL检查,并对脑白质区(双侧额叶白质、双侧顶叶白质、双侧内囊前支、双侧内囊后支、双侧外囊、双侧半卵圆区、双侧枕叶白质、双侧颞叶白质、胼胝体膝部、胼胝体体部及胼胝体压部)进行脑血流量(CBF)的测量,采用独立样本t检验对2组各区域CBF值进行统计分析,P<0.05为差异有统计学意义。分析重度OSAS组中具有统计学意义的脑白质低灌注区CBF值与AHI及蒙特利尔认知评估量表(MoCA)评分之间的相关性。结果重度OSAS组中右侧额叶白质、左侧额叶白质、右侧顶叶白质、左侧顶叶白质、右侧枕叶白质、左侧枕叶白质、右侧内囊后支及左侧内囊后支CBF值mL/(min·100 g)]分别为21.420±4.789、21.787±4.713、46.151±8.217、47.112±7.800、17.805±5.788、17.356±5.365、31.443±6.020、30.636±5.890,较健康对照组明显下降,差异均有统计学意义(均P<0.05);脑白质灌注减低区CBF值与AHI呈负相关,与MoCA评分呈正相关。结论 3D-ASL能敏感监测重度OSAS患者脑白质灌注异常,脑白质灌注异常与AHI值及认知功能障碍均存在相关性。
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| 关 键 词： | 动脉自旋标记 阻塞性睡眠呼吸暂停综合征 脑血流量 认知功能障碍 |
| 收稿时间： | 2018-02-01 |
Study of three dimensiona arterial spin labeling in white matter perfusion change and cognitive impairment of patients with severe OSAS |
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| Affiliation: | Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China |
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| Abstract: | Objective The three dimensional arterial spin labeling (3D-ASL) was used to study cerebral blood flow(CBF) in patients with severe obstructive sleep apnea syndrome (OSAS), and analyze the correlation of white matter perfusion abnormalities with apnea hypopnea index (AHI) and cognitive impairment. Methods Fifty-six cases of OSAS patients (AHI>30 times per hour) which were confirmed by clinic were included in this study. The control group had been set-up in age-matched 56 healthy volunteers without OSAS disease (AHI<5 times per hour). 3D-ASL sequences were examined in two groups of subjects using GE Discovery 750 MR. Cerebral blood flow (CBF) were measured in brain white matter (bilateral white matter of frontal lobe, parietal lobe white matter, bilateral anterior limb of the internal capsule, bilateral posterior limb of the internal capsule, bilateral external capsule, bilateral centrum semiovale, bilateral occipital lobe, bilateral temporal white matter and the genu of corpus callosum, corpus callosum and splenium of corpus callosum). Independent samples t test was used for statistical analysis of the two groups of the regional CBF. P values less than 0.05 were considered significant. The correlation between CBF value and AHI and MoCA score in the low perfusion areas was analyzed. Results CBF (mL/min·100 g) of the white matter area of severe OSAS group (the right frontal lobe white matter, left frontal lobe white matter, right parietal lobe white matter, left parietal lobe white matter, right occipital white matter and left occipital white matter, posterior branch of right and left internal capsule were 21.420±4.789, 21.787±4.713, 46.151±8.217, 47.112±7.800, 17.805±5.788, 17.356±5.365, 31.443±6.020, 30.636±5.890, respectively) were all decreased compared with the healthy control group (all P<0.05). The CBF value in the cerebral hypoperfusion areas were negatively correlated with the AHI value, and positively correlated with MoCA score. Conclusion White matter hypoperfusion areas could be found and measured in the severe OSAS patients by 3D-ASL sensitively, which correlated with the decline of cognitive function and apnea hypopnea index (AHI). |
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| Keywords: | Obstructive sleep apnea syndrome Arterial spin labeling Magnetic resonance imaging Cerebral blood flow |
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