基于体素的轻度阿尔茨海默病全脑灰质MRI成像分析

目的:利用磁共振T1 WI 3D成像研究轻度阿尔茨海默病患者相对于正常老年人灰质体积改变的特点.方法:对21例轻度AD患者及18例正常老年人进行三维T1WI扫描,利用基于SPM5的DARTEL工具箱对扫描获得的结构图像进行预处理,再对轻度AD组和对照组的令脑灰质体积进行基于体素的统计学比较.结果:轻度AD组的双侧海马、海马旁回及杏仁核、双侧丘脑、双侧颞枕叶皮质、双侧顶下小叶、双侧楔前叶、左侧中央后回、右侧额下回等结构与对照组的灰质密度差异具有统计学意义[P<0.05(FDR)].结论:基于体素的形态学研究能够发现轻度AD患者中大脑灰质广泛的及细微的结构萎缩,从而能够更加早期、全面、客观地反映轻度AD患者的脑结构改变.     

基于体素的形态测量学在阿尔茨海默病和轻度认知障碍中的应用价值

目的：应用基于体素的形态测量学（VBM）方法比较阿尔茨海默病（AD）和轻度认知障碍（MCI）患者和健康老年人灰质体积的不同,探讨VBM方法在AD、MCI诊断中的应用价值。方法：本研究包括10例AD患者（AD组）、9例MCI患者（MCI组）、10例老年健康志愿者（健康对照组）,检查系列包括头常规轴面T2WI、T1WI、轴面FLAIR、矢状面T1WI,全脑3D-SPGR。应用VBM方法处理数据,把脑组织分割成灰质、白质和脑脊液,最后应用两样本t检验两两比较灰质体积改变。结果：AD组与正常对照组脑灰质体积比较：AD组大脑皮层灰质体积弥漫减少,激活区域几乎分布整个大脑半球,以两侧内侧颞叶（海马、梨状皮层、内嗅皮层）为著。右侧海马减少的体素总数为2358个,左侧海马减少的体素总数为2967个,前后扣带回体素明显减少;MCI组与正常对照组比较：MCI组灰质减少的区域依然较多,但与AD和对照组相比,激活区域明显减少。其中最明显的是内侧颞叶内嗅皮层、海马旁回区域,右侧体素减少总数为1368,左侧1135;MCI组和AD组的比较：MCI组较AD组灰质减少的区域更多,内侧颞叶和海马区域基本没有激活区域,较明显的激活区域位于双侧额顶颞叶、扣带回。双侧尾状核头部和左侧丘脑亦有较明显激活,而豆状核没有明显激活。结论：内侧颞叶和海马体积减小是评价AD和MCI最敏感的区域,VBM可以有效评价灰质体积的改变。     

遗忘型轻度认知损害的全脑灰质基于体素的MRI形态分析

目的：利用优化基于体素的MRI形态分析（voxel-based morphometry,VBM）,研究遗忘型轻度认知损害（amnestic mild cognitive impairment,aMCI）和正常老年人的脑灰质体积变化。方法：选取aMCl患者20例和正常老年对照18例,MRI排除脑内其他病变,然后行高分辨率三维T1WI扫描。应用优化VBM方法处理数据,将脑组织分割成灰质、白质和脑脊液,最后应用两样本t检验比较两组被试灰质体积改变。结果：VBM结果显示与正常老年对照组比较,aMCI患者组双侧额颞叶出现广泛的灰质体积减少,具体脑区为右侧海马钩回、双侧额下回、双侧额中回、右侧额上回、双颞叶额中回、左侧颞下回、左侧颞上回、右侧顶上小叶、左侧枕中回等结构灰质体积小于对照组,差异有统计学意义（P〈0.001）。结论：VBM方法可显示aMCl患者全脑灰质萎缩情况,对临床早期诊断aMCl患者有重要价值,具有广阔的临床应用前景。     

基于体素的形态测量学方法研究屈光参差性弱视患儿的相关区域脑结构

目的 利用基于体素的形态测量学(VBM)分析屈光参差性弱视患者全脑灰、白质体积变化.方法 采用1.5 TMR扫描仪对12例屈光参差性弱视患儿和年龄、性别相匹配的12名正常志愿者行3D快速扰相梯度回波(FSPGR)序列的全脑扫描.原始数据用统计参数图(SPM)5软件进行处理.结果 与正常对照组相比,弱视组脑灰质体积减少的脑区包括右侧楔叶、双侧枕中下回、右侧额中回、左侧颞中回、右侧颞上回、右侧楔前叶、右侧中扣带回(差异脑区体素＞ 10个).弱视组脑灰质体积增多的脑区包括右侧小脑半球、右侧海马旁回、左侧中央前回、左侧额上回(差异脑区体素＞ 10个).与对照组比较,弱视组脑白质体积减少的脑区包括双侧视放射区、双侧内囊,以右侧为著(差异脑区体素＞10).未见弱视组脑白质体积增多的脑区.结论 运用VBM方法可分析屈光参差性弱视患者全脑灰、白质体积变化,有助于从形态学的角度阐述屈光参差性弱视的可能神经机制.     

基于体素的MRI形态分析诊断Alzheimer病的价值

目的评价基于体素的MRI形态分析（voxel-based Morphometry，VBM）法诊断Alzheimer病（AD）的价值。方法采用Siemens Sonata1．5T超导MR成像系统，对19例可能AD患者和15例年龄、性别与之相匹配的健康老年人及15例正常年轻人行全脑扫描，应用磁化准备快速梯度回波成像序列获取三维结构图像。数据分析采用以SPM99软件包为基础的全自动VBM技术进行处理。结果与健康老年对照组比较，AD患者两侧内颞叶（海马）明显萎缩（P〈0．001），右侧海马减少的体素总数为1529个，左侧海马减少的体素总数为1281个；而且AD患者右侧尾状核头和左侧内侧丘脑亦明显萎缩，减少的体素总数均为1529个；而感觉运动皮层、枕叶及小脑相对保持完好。此外，AD患者大脑皮层萎缩具有不对称性。结论VBM法操作简单，可自动化观察AD全脑萎缩情况，所得结论不仅与既往神经影像学研究结果一致，并得到了有重要价值的新发现，具有广阔的临床应用前景。     

冻结步态帕金森病患者脑部结构fMRI:基于体素的形态学分析

【摘要】目的：应用MRI基于体素形态学分析方法探讨冻结步态帕金森病（PD-FOG）患者的脑微观结构变化，分析PD-FOG患者脑灰质异常区域及分布特征。方法：将临床确诊的20例PD-FOG患者和18例非冻结步态帕金森病（PD-nFOG）患者纳入研究，并纳入性别、年龄和教育程度与患者组相匹配的21例健康志愿者作为对照组（HCs）。采集所有受试者的全脑3D-T1WI数据，并应用基于体素的形态学分析方法进行后处理和分析。结果：与PD-nFOG患者相比，PD-FOG患者脑灰质体积异常减少（P<0.005）的区域包括右侧额叶（BA4、BA6）和右侧顶叶（BA3、BA40）；与HCs相比，PD-FOG患者脑灰质体积异常减少（P<0.005）的区域包括右侧额叶（BA4、BA6）、右侧顶叶（BA3、BA40）和左侧小脑（山顶、山坡、小脑扁桃体和蚓结节）。结论：PD-FOG患者不仅存在运动相关脑区（顶叶及小脑）的灰质体积异常减少，而且额叶脑灰质体积也有减少，提示PD患者发生FOG可能是运动和认知功能障碍相互影响、相互作用所导致。     

基于体素的形态学测量无常规MR异常的颞叶癫痫的灰质改变

目的 利用基于体素的形态学分析(voxel-based optimized morphometry,VBM)及基于统计参数图的个体脑结构分析(individual brain atlases using SPM,IBASPM)软件,分析无常规MR异常的颞叶癫痫患者全脑灰质结构的改变.方法 对30例颞叶癫痫患者及40例正常健康志愿者行全脑扫描,扫描序列为磁化快速梯度回波(magnetization prepared rapid gradient echo,MPRAGE)扫描序列,获得高分辨T1WI图像,数据分析采用以SPM5(statistical parametric mapping 5)软件包为基础的VBM及IBASPM技术进行处理,利用SPSS16.0分别进行统计学分析.结果 通过比较,VBM显示颞叶癫痫患者双侧扣带前回、右侧扣带中回、左侧丘脑、双侧中央后回、左侧中央前回、左侧颞上回及右侧颞下回不同程度的灰质体素值减少,癫痫组灰质总体积明显小于对照组,有显著性差异(P<0.05).癫痫组的双侧扣带前回、右侧扣带中回、左侧颞上回及右侧颞下回灰质体素值均小于对照组相应脑区,差异有统计学意义(P<0.05),癫痫组的左侧丘脑、双侧中央后回、左侧中央前回灰质体素值与对照组无显著性差异(P>0.05).结论 利用VBM及IBASPM技术,说明无常规MR异常的颞叶癫痫灰质总体积明显减小,并显示局灶性灰质体素值改变的脑区,提示了病变的主要部位,为临床精确治疗提供信息.     

轻度尼古丁依赖对人体大脑灰质结构影响的MRI评价

【摘要】目的：应用MRI基于体素的形态学分析法（VBM）评估轻度尼古丁依赖者脑灰质结构的改变。方法：使用Siemens Skyro 3.0T磁共振扫描仪对77例轻度尼古丁依赖者（FTND评分<6分）和37例不吸烟的健康志愿者进行扫描,包括常规MRI序列及高分辨三维T1加权磁化梯度回波序列（3D-MPRAGE,结构像）。结构像数据采用基于Matlab平台的SPM8软件进行数据处理和分析,对轻度尼古丁依赖组与对照组的灰质体积进行两独立样本t检验（FWE校正,P<0.05,簇体素>318voxels）,将两组间灰质体积（GMV）差异区与吸烟情况进行Spearman相关分析。结果：与对照组比较,轻度尼古丁依赖组双侧丘脑和双侧缘上回的GMV减小,未发现GMV增大的脑区。右侧和左侧丘脑、右侧缘上回的GMV与吸烟指数呈负相关（r=-0.489、-0.500和-0.312,P<0.05）,与吸烟年限也呈负相关（r=-0.497、-0.555和-0.351,P<0.05）,右侧丘脑GMV还与日吸烟量呈负相关（r=-0.260,P<0.05）。结论：吸烟者脑灰质结构的改变主要集中在奖励相关通路及边缘系统,且脑灰质体积与吸烟的累积量相关 。     

多发性硬化的深部灰质核团和边缘叶萎缩:基于体素的形态学研究

目的:采用基于体素的形态学(VBM)方法探讨多发性硬化患者的脑灰质变化.方法:应用3.0T MRI,对25例复发缓解型多发性硬化(RRMS)患者和22例正常志愿者进行3D T1WI扫描,通过基于体素的形态学分析全脑灰质和区域灰质核团的变化.结果:与正常对照组比较,多发性硬化的全脑灰质明显萎缩( 679.40±52.68...     

基于体素的遗忘型轻度认知障碍和轻度阿尔茨海默病全脑白质MR扩散张量成像分析

目的 采用基于体素的分析(VBA)方法研究遗忘型轻度认知障碍(aMCI)患者和轻度阿尔茨海默病(AD)患者全脑白质微观结构改变的特点及其与灰质萎缩模式的关系.方法 选取33例aMCI患者(aMCI组)、32例轻度AD患者(轻度AD组)和31名正常老年人(健康对照组),对全脑进行3.0 T DTI及三维快速扰相梯度反转回波(3DFSPGR)脉冲序列扫描.采用统计参数图(SPM)5软件对被试者的结构图像及各向异性(FA)图进行预处理,然后采用t检验对aMCI组、轻度AD组和正常对照组的全脑灰质体积及FA值进行基于体素的统计学比较,计算出有统计学意义的脑区.结果 与正常对照组比较,aMCI组的双侧额颞叶和左侧枕叶白质、左侧扣带前部、左侧顶下小叶、右侧脑室三角区外上方白质的FA值减低;轻度AD组的双侧额颞枕叶、海马旁白质、扣带前部、胼胝体、侧脑室三角区旁白质、顶下小叶、左侧颞于、左侧丘脑、右侧楔前叶FA值减低.基于体素的形态测量学(VBM),分析发现,aMCI患者组左侧海马、海马旁回、舌回、颞上回,双侧岛叶、颞中回出现了灰质萎缩;轻度AD患者组双侧海马、海马旁回、杏仁核、丘脑、额叶、颞叶、顶叶、枕叶皮质出现了灰质萎缩.aMCI与轻度AD患者组全脑白质FA值减低的模式与灰质萎缩模式不同.aMCI组与轻度AD组比较未发现具有统计学意义的FA值减低脑区.aMCI、轻度AD患者组全脑白质FA值与简易智能精神状态检查量表(MMSE)评分没有相关性.结论 基于体素的MR DTI全脑白质分析能够较全面、客观地揭示aMCI、轻度AD的脑白质损害的模式.aMCI、轻度AD患者白质损害的模式与灰质不同,提示脑白质病变是多种病理机制导致的.aMCI患者向轻度AD进展过程中,脑白质各向异性改变不显著,脑白质FA值的改变可能无法反映患者认知功能障碍的严重程度.

Abstract：

Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.     

基于体素的形态测量学方法对慢性类风湿关节炎患者脑灰质的MR研究

目的 应用基于体素的形态测量学(VBM)方法分析慢性类风湿关节炎(RA)患者相对于健康志愿者脑灰质改变的特点及规律.方法 收集35例慢性RA患者和30例年龄、性别、受教育程度相匹配的健康对照者,使用GE Signa HDxt 1.5T超导MR扫描仪对所有受试者行高分辨率3D-T1全脑结构扫描,利用SPM 12软件的VBM 12方法对扫描图像进行预处理,对慢性RA患者和正常志愿者脑灰质体积采用双样本t检验,探讨慢性RA患者脑灰质改变的特点及其与临床指标的相关性.结果 与对照组相比,VBM结果显示慢性RA患者右侧豆状核,左侧额叶及左侧小脑后叶脑灰质减少,差异脑区脑灰质与临床指标之间无线性相关性.本研究未发现慢性RA组脑灰质比正常对照组增大的区域.结论 慢性RA患者脑灰质减小,提示RA可导致脑结构异常,VBM为评价RA脑形态学异常提供了客观的影像学依据.     

Voxel-based morphometric comparison between early- and late-onset mild Alzheimer's disease and assessment of diagnostic performance of z score images

BACKGROUND AND PURPOSE: Voxel-based morphometry (VBM), used for detecting brain atrophy, permits comparison of local gray matter concentration at every voxel in an image between two groups. We sought to delineate the specific patterns of cerebral gray matter loss with regard to onset of Alzheimer's disease (AD) by using MR imaging and VBM and to evaluate the diagnostic performance of VBM with Z score images. METHODS: Two groups of 30 patients with mild AD of different ages of onset were examined. Mean ages in the early- and late-onset groups were 60.2 +/- 5.2 and 71.5 +/- 2.6 years, respectively. Control subjects were aged-matched healthy volunteers. Regions of gray matter loss in early- and late-onset AD were examined with VBM. Diagnostic performance of Z score images obtained with the VBM method was evaluated in patients and control subjects by calculating the area under the receiver operating characteristic curve (A(z)). RESULTS: Both AD groups had significantly reduced gray matter in the bilateral medial temporal regions. In addition, the early-onset group had more severe gray matter loss in the bilateral parietal and posterior cingulate cortices and precuneus region. No difference was noted in diagnostic performance of Z score images between the early- (A(z) = 0.9435) and late-onset (A(z) = 0.9018) groups. CONCLUSION: Differences were noted in the patterns of regional gray matter loss in patients with early-onset AD versus those with late-onset AD. Parietotemporal and posterior cingulate gray matter loss was found in early-onset AD but not in late-onset AD. Z score images obtained with VBM had a great diagnostic performance for mild AD and can be applied for detecting mild AD in clinical examinations.     

Comparison of gray matter and metabolic reduction in mild Alzheimer’s disease using FDG-PET and voxel-based morphometric MR studies

Purpose The aim of this study was to investigate regional differences between morphologic and functional changes in the same patients with mild Alzheimers disease (AD) using statistical parametric mapping (SPM) and voxel-based morphometry (VBM).Methods Thirty patients with very mild AD (mean age 66.8 years, mean MMSE score 24.0) and 30 age- and sex-matched normal volunteers underwent both ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and three-dimensional spoiled gradient echo (SPGR) magnetic resonance imaging (MRI). Statistical parametric mapping was used to conduct VBM analysis of the morphological data, which were compared voxel by voxel with the results of a similar analysis of the glucose metabolic data.Results In AD patients, VBM data indicated a significant gray matter volume density decrease in bilateral amygdala/hippocampus complex (p<0.05, corrected), while FDG-PET analysis showed significant glucose metabolic reductions in the posterior cingulate gyri and the right parietal lobule, compared with those in the normal control group.Conclusion In very mild AD, morphological change occurs in the medial temporal lobes, while in contrast, metabolic changes occur in the posterior cingulate gyri and parietal lobule.     

帕金森病认知障碍患者脑结构的体素形态学研究

目的：分析帕金森病(PD)患者脑灰质异常区域及分布特征,探寻与轻度认知障碍(MCI)有关的脑结构变化。方法采用基于体素的形态学测量(VBM)方法,对20例伴 PD-MCI 患者、17例无轻度认知障碍 PD(PD-nMCI)患者及20例正常对照组(NC)的3组3D-T1 WI 脑容积数据进行处理统计,得到3组全脑灰质图像。结果与 NC 组相比,PD-nMCI 组脑灰质体积异常减少的脑区包括：右侧梭状回、右颞中下回、右钩回及左侧颞上回。与 PD-nMCI 组相比,PD-MCI 组脑灰质体积异常减少的脑区包括：两侧额叶(两额中下回、左侧中央前回)、颞叶(右颞中回、左颞上回)、岛叶、右枕叶(右楔叶、舌回)、右后扣带回。结论PD-nMCI 患者灰质体积的缺失相对局限,随认知障碍的出现、发展,缺失脑区的范围逐渐扩大,其中两侧额叶中下回、左侧中央前回的体积缺失与 PD 患者的 MCI 关系密切。     

应用全脑逐像素形态学自动分析方法研究阿尔茨海默氏病的灰质缺失

目的采用计算机处理核磁共振图像(magnetic resonance imaging,MRI),研究阿尔茨海默氏病(Alzheime's disease,AD)患者的灰质萎缩区域。方法采用逐像素形态学(voxeI-based morphometry,VBM)方法。结果和正常老年人对照组相比,AD病人的海马、海马旁回、内嗅皮层、杏仁体、尾状核头部、颞中回、扣带回、顶下小叶、岛叶和前额叶背外侧区双侧萎缩；右侧丘脑枕、颞上回、顶上小叶不同程度萎缩,而感觉运动皮层、小脑和枕叶相对保持完好。结论 VBM方法克服了以往使用人工勾画感兴趣区(ROI)方法的可重复性差,费时等缺点,可以客观、自动和全面地分析AD的灰质减少,具有良好的临床应用前景。     

Comparison of the diagnostic performance of FDG-PET and VBM-MRI in very mild Alzheimer’s disease

Purpose The aim of this study was to compare the diagnostic performance of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and voxel-based morphometry (VBM) on magnetic resonance imaging (MRI) in the same group of patients with very mild Alzheimer’s disease (AD). Methods Thirty patients with very mild AD (age 67.0±5.8 years; MMSE score 25.5±1.2, range 24–28), 32 patients with mild AD (age 67.0±4.5 years, MMSE score 22.1±0.8, range 21–23) and 60 age- and sex-matched normal volunteers underwent both FDG-PET and three-dimensional spoiled gradient echo MRI. Statistical parametric mapping was used to conduct voxel by voxel analysis and Z score mapping. First, the region of interest (ROI) maps of significant reductions in glucose metabolism and grey matter density in the mild AD patients were defined. Secondly, analysis of receiver operating characteristic (ROC) curves for Z scores in the ROI maps discriminating very mild AD patients and normal controls was performed. Results In mild AD patients, FDG-PET indicated significant reductions in glucose metabolism in the bilateral posterior cingulate gyri and the right parietotemporal area, while VBM analysis showed a significant decrease in grey matter volume density in the bilateral amygdala/hippocampus complex, compared with the normal control group. ROC analysis showed that in very mild AD patients the accuracy of FDG-PET diagnosis was 89% and that of VBM-MRI diagnosis was 83%. The accuracy of the combination of FDG-PET and VBM-MRI diagnosis was 94%. Conclusion In very mild AD, both FDG-PET and VBM-MRI had high accuracy for diagnosis, but FDG-PET showed slightly higher accuracy than VBM-MRI. Combination of the two techniques will yield a higher diagnostic accuracy in very mild AD by making full use of functional and morphological images.     

基于体素的形态测量学在震颤麻痹型多系统萎缩中的应用

目的 评价震颤麻痹型多系统萎缩(MSA-P型)患者全脑灰、白质体积减少区域及分布特征.方法 选取13例临床拟诊为MSA-P型可能性大的患者及14名年龄匹配的正常对照者行全脑三维快速扰相梯度回波(3D fast spoiled gradient echo,3D-FSPGR)序列扫描,采用基于体素的形态测量学(voxel-based morphometry,VBM)分析方法的统计参数图软件(statistical parametric mapping,SPM)8,对MSA-P型患者及正常对照者的灰、白质体素进行分析.结果 与正常对照者相比,MSA-P患者的脑灰、白质体积均减少;脑灰质减少区多数区域呈双侧对称分布:包括双侧辅助运动区、背侧后扣带皮层、额叶内侧回、颞上回、小脑半球皮层等;少数区域仅累及单侧,如右侧初级运动皮层、体感联合皮层及左侧下前扣带皮层等.脑白质区主要累及双侧额上回、楔前叶、额叶下,左侧颞上回、扣带回及右侧额眶回、颞叶下等.结论 VBM方法具有自动、全面的特点,能客观地反映MSA-P患者组全脑结构的差异.     

Comparison of grey matter and metabolic reductions in frontotemporal dementia using FDG-PET and voxel-based morphometric MR studies

Purpose  The aim of this study was to investigate the regional differences between the morphologic and functional changes in the same patients with frontotemporal dementia (FTD) using statistical parametric mapping and voxel-based morphometry (VBM). Methods  Thirteen FTD patients (mean age, 64.9 years old; mean MMSE score, 17.7), 20 sex-matched Alzheimer’s disease (AD) patients (mean age, 65.0 years old; mean MMSE score, 17.5), and 20 normal volunteers (mean age, 65.2 years old; mean MMSE score, 29.0) underwent both [¹⁸F]FDG positron emission tomography and three-dimensional spoiled gradient echo MRI. Statistical parametric mapping was used to conduct a VBM analysis of the morphologic data, which were compared voxel by voxel with the results of a similar analysis of glucose metabolic data. Results  FTD patients showed decreased grey matter volume and decreased glucose metabolism in the frontal lobe and anterior temporal lobe. In addition, there was a clear asymmetry in grey matter volume in FTD patients by the VBM analysis while the glucose metabolic data showed little asymmetry. In AD patients, glucose metabolic reduction occurred in the bilateral posterior cingulate gyri and parietal lobules while grey matter density decreased the least in the same patients. Conclusion  In FTD, metabolic and morphologic changes occur in the bilateral frontal lobe and temporal lobe with a limited asymmetry whereas there was considerable discordance in the AD group.     

帕金森病的脑灰质体积改变的VBM研究

目的 分析帕金森病(PD)患者的全脑灰质体积的变化,探讨PD患者的脑灰质结构异常模式.方法 选取符合入组标准的46例PD患者和19例年龄、性别与之相匹配的正常对照(NC)被试者作为研究对象.46例PD患者按改良的Hoehn-Yahr (H-Y)分级标准又分为2个亚组,25例早期PD(ePD)组和21例中晚期PD(maPD)组.所有受试者在3.0T超高场磁共振仪进行常规磁共振扫描,并获取三维高分辨T1WI数据,采用VBM-DARTEL(voxel-based morphometry-diffeomorphic anatomical registration through exponentiated lie)方法分析比较PD组与NC组、ePD组与maPD组间的脑灰质体积差异.结果 与NC组相比,PD组双侧额叶、颞叶、岛叶、扣带回、海马、梭状回、小脑及右侧楔叶、楔前叶等脑区的灰质体积减小,全脑灰质未见体积增加.与ePD组相比,maPD组双侧额叶、颞叶、岛叶、扣带回、直回、舌回、梭状回、海马、杏仁核及小脑等脑区的灰质体积减小.结论 VBM方法客观提示了PD存在广泛的脑灰质萎缩,且随病程的进展更为显著.PD脑结构的变化存在特定的空间分布模式,可能与PD的病理基础有关.