平原正常成人脑的高海拔适应性改变：静息态f MR I研究

目的：应用基于体素形态学(VBM)、低频振幅(ALFF)和局部一致性(ReHo)方法探讨平原正常成人脑结构及脑功能对高海拔低氧的适应性变化。方法对19例年龄、受教育程度、原居住地海拔高度相匹配的初入高海拔1周内的平原成人行静息态功能磁共振(fMRI)全脑扫描,移居1年后同批受检者再行此检查,应用 VBM技术、ALFF 和 ReHo 方法对脑功能数据进行分析。结果平原正常成人移居高海拔地区1年前后自身脑结构比较,未发现显著性差异;在静息状态下,脑功能方面存在显著性差异,移居高海拔1年后受检者左侧额中回 ALFF增加,右侧舌回的 ALFF减低(P<0.01);左侧眶内额上回的 ReHo增加,右侧楔叶、右侧顶叶 ReHo减低(P<0.05)。结论正常成人移居高海拔1年后存在脑功能的改变,这可能与长期处于低氧环境有关。     

应用基于体素的形态测量学方法分析视神经脊髓炎患者的脑体积变化

目的 应用基于体素的形态测量学方法(VBM)比较视神经脊髓炎(NMO)患者和正常志愿者局部脑灰质和白质的体积差异,并分析脑体积变化与临床指标的相关性.方法 对20例NMO患者和20例性别、年龄匹配的健康志愿者进行常规MRI和三维结构像扫描,采用统计参数图(SPM)5的VBM工具对NMO组及对照组数据进行分析,比较两组之间脑灰质和白质体积的差异.利用Pearson相关分析脑灰、白质异常的区域与患者病程和临床评分的相关性.结果 与对照组相比,NMO患者右侧额下回(体素数514)、左侧颞上回(282)、右侧颞中回(229)及右侧岛叶(211)等多个灰质脑区体积减小(t值为3.58～5.11,P值均＜0.05);NMO患者右侧中央前回、后回(体素数457、110)、左侧额中回(285)及右侧顶下小叶(231)等多个皮层下白质脑区体积减小(t值为2.90～4.25,P值均＜0.05).NMO脑灰、白质体积异常的区域与临床病程及残疾状态评分均无明显相关性.结论 应用VBM方法能发现NMO患者灰、白质局部脑区的萎缩,为NMO脑结构异常提供影像证据.     

急性酒精中毒对记忆功能影响的功能性磁共振研究进展

随着磁共振成像技术的不断发展,多模态磁共振研究急性酒精中毒如何影响记忆、情感及奖励机制取得了一定进步,功能磁共振成像能够提供非侵入性的脑功能检测,评价认知功能.然而单一的成像方法难以阐明急慢性酒精相关性脑损害的功能和结构特征,同时运用两种或多种神经成像方法,例如动脉自旋标记(ASL)、功能磁共振成像(fM-RI)、基于体素的形态学分析法(VBM)和磁共振波谱成像(MRS)等在临床工作中已变得越来越重要.本文就急性酒精中毒的磁共振脑功能成像的相关研究进展进行综述.     

基于体素的形态学测量技术临床应用进展

基于体素的形态学测量(VBM)能定量计算局部脑灰、白质密度和体积的改变,可更精确地显示常规影像检查不能发现的多种神经病变所引起的脑组织形态学改变,为阐明病理机制和病程监测提供了有力工具.     

自身免疫性脑炎的MRI研究进展

自身免疫性脑炎（AE）是一组由抗神经元抗体导致的炎性脑病,炎症进程可以发生在大脑边缘系统等多个脑区。在常规MRI上常表现为T₂WI及T₂-FLAIR高信号,并有扩散受限,但仍有部分AE常规MRI表现为阴性;而高级MRI技术包括结构和功能MRI,可以利用基于体素的形态学分析（VBM）、基于表面的形态学分析（SBM）、扩散张量成像（DTI）及静息态功能连接（FC）、低频振幅（ALFF）、脑网络和任务态功能MRI（fMRI）等方法从多角度研究AE脑结构及功能改变,有助于探索疾病潜在的神经病理机制。就AE的常规MRI表现及高级MRI研究进展予以综述。     

基于体素的形态学分析研究皮层下脑梗死患者脑结构的改变

目的 利用基于体素的形态学分析(VBM)研究慢性期缺血性脑梗死患者脑结构可塑性及其与认知功能之间的关系.方法 采用3.0T MR对29例运动功能恢复良好的慢性期皮层下脑梗死患者及30例健康志愿者行全脑高分辨3D-T1WI扫描.采用以统计参数图SPM8为基础的VBM技术进行数据分析,比较患者组与对照组灰、白质体积存在差异的脑区.对体积增加的脑区及体积减小的脑区做相关分析,并将灰质体积存在差异的脑区与认知功能评分做相关分析.结果 脑梗死组患侧丘脑灰质体积减小,梗死病灶周围白质体积减小,而健侧辅助运动区(SMA)及枕中回灰质体积增加.增加的灰质体积与减少的脑实质体积呈负相关,健侧枕中回增加的灰质体积与认知功能呈正相关.结论 慢性期运动功能恢复良好的皮层下脑梗死患者同时存在结构损伤和结构重塑的现象,相关脑区结构的变化与认知功能存在相关性.     

慢性阻塞性肺部疾病早期脑部灰、白质VBM及DTI研究

目的运用基于体素形态学分析(voxel-based morphometry, VBM)及弥散张量成像(diffusion tensor imaging, DTI)技术探讨慢性阻塞性肺气肿(chronic obstructive pulmonary disease, COPD)患者慢性缺氧所致的脑灰、白质结构病理变化。方法收集COPD患者30例及年龄相匹配的正常志愿者30例。所有入组者均运用Philips 3.0T MR进行T_2、FLair,DTI及全脑3D-T_1WI。运用VBM8软件处理,得到全脑灰质密度数据参数图。利用Philips工作站处理DTI信息,勾画出长联络纤维。以VBM结果所得灰质减少区为种子勾画弓状纤维,测量白质纤维束的FA、ADC值。一般资料及FA、ADC计数资料对比均应用SPSS 17.0进行t检验统计分析。结果 VBM结果显示,COPD患者组对比正常组,全脑多个区域灰质密度减小,包括右侧颞下回、右侧额眶回、左侧海马旁回、右侧颞极、双侧尾状核、双侧前运动皮层、左侧缘上回、右侧岛叶。DTI测量示:双侧尾状核FA值,右侧岛叶,双侧皮质脊髓束、左侧扣带束、左侧勾束FA降低,P0.005。结论 COPD患者脑区存在多个灰、白质区域异常,提示COPD患者在常规MRI未出现异常情况下已有微观脑结构改变。VBM及DTI技术可检测疾病早期脑结构病理改变,对临床评估有一定意义。     

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.     

用优化的基于体素的形态学方法研究初发精神分裂症患者脑结构的MRI特征

目的运用优化的基于体素的形态学研究（VBM），探索中国汉族人群精神分裂症患者与正常人脑结构之间的差异。方法运用高场强（3．0T）MR扫描仪分别采集13例初发且未经治疗的精神分裂症患者和13名年龄、性别、利手配对的正常人（对照组）的高分辨T1WI。采用优化的VBM方法处理所有数据，最后经两样本配对t检验，比较2组间的脑灰质密度和灰质体积的差别。结果采用国际通用的统计参数图表示。结果精神分裂症患者的脑灰质体积较对照组缩小、密度较对照组广泛降低。这些区域主要集中于脑双侧颞叶和额叶区域，包括双侧额中回、双侧岛叶等区域，另一些灰质密度降低区散在分布于脑顶叶、枕叶及小脑区域。结论优化的VBM可能是一种自动的，有效的研究精神分裂症患者脑结构的方法；初发精神分裂症患者的脑灰质密度较正常人广泛降低，体积较正常人缩小。     

热性惊厥附加症儿童的脑灰质形态学分析

目的:采用基于体素形态学测量(VBM)及基于表面形态学测量(SBM)方法,探讨热性惊厥附加症(FS+)儿童的脑灰质结构变化.方法:选取20例FS+患者及与之性别、年龄及受教育程度匹配的19名正常对照者进行磁共振3D T1结构像序列扫描,应用SPM12中VBM及CAT12工具箱进行全脑灰质体积、皮质厚度、脑沟深度、沟回指...     

基于体素的形态学分析技术在评价脑灰质体积改变对皮质下缺血性血管性痴呆患者执行功能影响中的应用

目的:采用基于体素的形态学分析(VBM)技术分析皮质下缺血性血管性痴呆(SIVD)患者执行功能障碍与相关脑区灰质体积改变之间的关系.方法:分别纳入SIVD患者和健康志愿者各14例,应用VBM技术比较2组的脑灰质体积差异,分析脑灰质体积变化与执行功能的相关性.结果:与健康对照组相比,SIVD患者灰质体积显著减少,包括全脑...     

轻度Alzheimer患者与正常老年人全脑灰质基于体素的形态学比较

目的 利用基于体素的形态学研究方法比较轻度Alzheimer病（AD）患者和正常老年人全脑灰质的差别。方法 对16例正常志愿者和13例轻度AD患者进行了三维T1WI扫描，数据在参数统计软件包SPM99下进行头颅标准化、分割、平滑的后处理后，对AD组和对照组的全脑灰质进行基于体素的统计学比较。结果 AD组的双侧海马及杏仁核、双侧岛叶、双侧内侧丘脑、双侧直回、右侧颞上回、右侧尾状核、右侧前额叶、右侧前脑基底部和有侧部分枕叶与对照组的灰质密度差异具有统计学意义（P〈0．001），这些区域的体素数目从36个至282个不等。结论 基于体素的形念学研究能够发现AD患者中广泛的大脑灰质的萎缩，从而更加全面地评价AD患者的脑结构改变。     

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.     

Brain perfusion SPECT: age- and sex-related effects correlated with voxel-based morphometric findings in healthy adults.

PURPOSE: To investigate brain perfusion at single photon emission computed tomography (SPECT) as a function of age and sex in healthy adult volunteers and to correlate perfusion with gray matter concentration determined by using voxel-based morphometry (VBM). MATERIALS AND METHODS: Eighty-one healthy volunteers underwent both technetium 99m ethylene cysteine dimer SPECT and three-dimensional magnetization preparation rapid acquisition gradient-echo magnetic resonance (MR) imaging. Statistical parametric mapping was used to conduct VBM analysis of the morphologic data, which were compared voxel by voxel with the results of a similar analysis of the perfusion data and more specifically in brain areas showing significant perfusion changes. RESULTS: VBM data, as compared with perfusion changes, indicated a more symmetric age-related gray matter volume decrease along the Sylvian fissure and in subcortical regions (P < .001). The combination of functional and structural changes indicated a relatively lower functional decrease with aging, as compared with the structural atrophy in the visual, parietal, sensorimotor, and right prefrontal cortices. Significant relative morphologic sex-based differences were found in the cerebellar and temporal cortices, but the comparison did not reveal significant differences between the functional and morphometric data. CONCLUSION: Age-related perfusion changes are paralleled by similar more symmetric changes in gray matter concentration, which are more prominent than the perfusion changes in some regions. No sex-based differences between perfusion and gray matter concentration were found.     

Partial volume effect-corrected FDG PET and grey matter volume loss in patients with mild Alzheimer’s disease

Purpose Although ¹⁸F-fluorodeoxyglucose (FDG) PET is an established imaging technique to assess brain glucose utilisation, accurate measurement of tracer concentration is confounded by the presence of partial volume effect (PVE) due to the limited spatial resolution of PET, which is particularly true in atrophic brains such as those encountered in patients with Alzheimer’s disease (AD). Our aim was to investigate the effects of PVE correction on FDG PET in conjunction with voxel-based morphometry (VBM) in patients with mild AD. Methods Thirty-nine AD patients and 73 controls underwent FDG PET and MRI. The PVE-corrected grey matter PET images were obtained using an MRI-based three-compartment method. Additionally, the results of PET were compared with grey matter loss detected by VBM. Results Before PVE correction, reduced FDG uptake was observed in posterior cingulate gyri (PCG) and parieto-temporal lobes (PTL) in AD patients, which persisted after PVE correction. Notably, PVE correction revealed relatively preserved FDG uptake in hippocampal areas, despite the grey matter loss in medial temporal lobe (MTL) revealed by VBM. Conclusion FDG uptake in PCG and PTL is reduced in AD regardless of whether or not PVE correction is applied, supporting the notion that the reduced FDG uptake in these areas is not the result of atrophy. Furthermore, FDG uptake by grey matter tissue in the MTL, including hippocampal areas, is relatively preserved, suggesting that compensatory mechanisms may play a role in patients with mild AD. Disclosure: The authors have reported no conflicts of interest.     

基于体素的形态测量学技术在视神经脊髓炎脑改变中的初步应用

目的 通过基于体素的形态测量学(VBM)技术研究视神经脊髓炎(NMO)患者的脑体积变化情况,初步从结构方面探讨NMO的脑损害模式.方法 对23例NMO患者和15名健康志愿者进行脑部3D快速扰相梯度回波(FSPGR)序列扫描.原始数据用统计参数图(SPM)5软件进行处理.采用t检验比较两组全脑体积的差别,应用Pearson相关分析评价全脑体积和年龄的相关性.结果 NMO组患者的全商灰质体积[(610.2±55.0)ml]明显小于健康对照组[(657.2±36.3)ml],差异有统计学意义(t=-2.915,P＜0.05).NMO患者的年龄[(40±9)岁]与脑灰质分数[(42.5±2.6)%]呈负相关(r=-0.673,P＜0.05).局部脑体积分析结果显示,与健康对照组相比,NMO灰质体积减少主要集中在左侧岛叶和双侧后扣带回,白质体积减少区主要位于左侧额叶和左侧顶叶皮层下白质.结论 VBM技术可以敏感地检测NMO的脑体积变化情况.NMO患者的脑体积较健康对照组有减少的趋势,以灰质萎缩更明显.

Abstract：

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.     

The efficacy of a voxel-based morphometry on the analysis of imaging in schizophrenia, temporal lobe epilepsy, and Alzheimer's disease/mild cognitive impairment: a review

Voxel-based morphometry (VBM) done by means of MRI have provided new insights into the neuroanatomical basis for subjects with several conditions. Recently, VBM has been applied to investigate not only regional volumetric changes but also voxel-wise maps of fractional anisotropy (FA) computed from diffusion tensor imaging (DTI). The aim of this article is to review the recent work using VBM technique in particular focusing on schizophrenia, temporal lobe epilepsy (TLE), and Alzheimer's disease (AD)/mild cognitive impairment (MCI). In patients with schizophrenia, VBM approach detects the structural brain abnormalities that appear normal on conventional MRI. Moreover, this technique also has the potential to emerge as a useful clinical tool for early detection and monitoring of disease progression and treatment response in patients with schizophrenia or AD/MCI. In TLE, VBM approach may help elucidate some unresolved important research questions such as how recurrent temporal lobe seizures affect hippocampal and extrahippocampal morphology. Thus, in the future, large cohort studies to monitor whole brain changes on a VBM basis will lead to a further understanding of the neuropathology of several conditions.     

中国食蟹猴脑磁共振图像模板的构建

目的建立中国食蟹猴脑结构T1图像模板,分析其脑灰质、白质及脑脊液组织概率分布图。方法 16只健康中国食蟹猴3.0TMRI脑的高分辨3D矢状位T1WI采集,使用模糊C均值聚类（fuzzy c-meass clusteriag Algorithm,FCM）法对每例图像进行组织分割、插值、空间标准化及图像平滑,建立脑白质、灰质、脑脊液组织概率图和个体脑模板。对所得图像进行配准及平均后,再经过VBM流程分析测试获得食蟹猴MRI图像模板。结果建立了正常中国食蟹猴脑结构3D模板,并获得了食蟹猴脑白质、灰质、脑脊液三种组织的概率图,清晰地显示了全脑T1加权对比结构。结论建立MRI图像模板和组织概率图为中国食蟹猴脑结构VBM分析和fMRI定位提供了重要的基础和便利。     

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.