基于体素的形态学方法评价急性脊髓损伤患者脑灰白质体积改变

目的 采用基于体素的形态学（VBM）分析方法探讨急性脊髓损伤（SCI）患者脑灰白质体积改变。方法 对16例急性SCI患者（受伤时间< 30天，SCI组）和20名年龄、性别匹配的正常志愿者（对照组）行脑3D T1W序列扫描，采用VBM分析方法比较2组脑灰白质体积，获得脑灰质体积差异有统计学意义的脑区；测量或计算脑组织体积（BTV）、全脑体积（TIV）、脑灰质体积（GMV）、脑白质体积（WMV）、脑脊液体积（CSFV）和脑灰质分数（GMF）、脑白质分数（WMF）和脑组织分数（BTF）。结果 与对照组相比，SCI组双侧下额叶、岛叶、内侧前额叶及前扣带皮质、小脑后叶灰质体积减小，内囊水平皮质脊髓束体积减小。SCI组与对照组间GMV、WMV、CSFV、BTV、TIV及GMF、WMF、BTF差异均无统计学意义（P均> 0.05）。结论急性SCI导致远隔部位情绪处理相关脑区灰质及皮质脊髓束萎缩，有助于探讨急性SCI对大脑结构产生影响的作用机制。

Evaluation of gray and white matter volume of brain changes in patients with acute spinal cord injury using voxel-based morphometry

Objective To explore the volume changes of gray and white matter in patients with acute spinal cord injury (SCI) based on voxel-based morphometry (VBM) analysis. Methods A total of 16 patients with acute SCI (mjury time < 30 days, SCI group) and 20 healthy controls (control group) were enrolled and underwent 3D T1W scanning of whole brain. The volume changes of gray and white matter were compared between the 2 groups based on VBM analysis, and the cerebral regions with different gray matter volume were obtained. The brain tissue volume (BTV), gray matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), cerebrospinal fluid volume (CSFV) and gray matter fraction (GMF), white matter fraction (WMF) as well as brain tissue fraction (BTF) were measured or calculated. Results Compared with control group, the volume of gray matter in bilateral lower frontal lobes, the insula, the medial prefrontal lobe, the anterior cingulate cortex and the posterior cerebellar lobe decreased in SCI group, and the volume of bilateral inner corticospinal tract of the inner capsule decreased. There was no significant difference of GMV, WMV, CSFV, BTV, TIV nor GMF, WMF, BTF between SCI group and control group (all P>0.05). Conclusion Acute SCI leads to atrophy of the cortices associated with emotional processing and the corticospinal tracts, which may provide better understanding of the mechanisms of impact of acute SCI on the brain.