DTI对HIV感染者脑白质细微结构病变的诊断研究

目的 探讨扩散张量成像(DTI)技术对人类免疫缺陷病毒(HIV)感染者脑白质细微病变的诊断和临床应用价值.方法选取80例HIV阳性者(阳性组)和83例HIV阴性者(对照组),均行MRI常规序列及DTI扫描.测定双侧内囊前支、内囊后支、内囊膝、胼胝体膝部、压部及双侧胼胝体干脑白质感兴趣区(ROI)的各向异性分数(FA)值和表观扩散系数(ADC)值,利用独立样本t检验比较2组间FA值及ADC值的差异.结果与正常对照组相比,阳性组双侧内囊前支及内囊膝、胼胝体膝部及双侧胼胝体干FA值均低于对照组,差异有统计学意义(P<0.05);阳性组双侧内囊前支、后支、膝部及双侧胼胝体干ADC值均高于对照组,差异亦有统计学意义(P<0.05).结论DTI通过FA值和ADC值的异常改变而发现HIV阳性患者内囊及胼胝体区脑白质结构的细微病变,为临床早期诊断和治疗干预提供参考依据.

Diffusion tensor imaging study in the diagnosis of white matter micro-structural alterations in HIV patients

Objective To investigate the diagnostic and clinical application value of diffusion tensor imaging (DTI)in white matter micro-structural alterations of HIV patients.Methods 80 HIV-positive patients and 83 normal volunteers were underwent conven-tional MRI and DTI.Fractional anisotropy (FA)and apparent diffusion coefficient (ADC)values were measured in several regions:anterior limbs of internal capsule,posterior limbs of internal capsule,genu of internal capsule,genu of corpus callosum,splenium of corpus callosum,and trunk of corpus callosum.The differences of mean FA value and ADC value between HIV group and normal group were compared by independent sample t statistical test.Results Compared with normal group,HIV group has much lower FA values in anterior limbs of internal capsule,genu of internal capsule,genu of corpus callous,and trunk of corpus callous,and has higher ADC values in anterior limbs of internal capsule,posterior limbs of internal capsule,genu of internal capsule,and trunk of corpus callosum,which have significant statistical difference (P<0.05).Conclusion DTI can show the micro-structural alterations of the internal capsule and corpus callosum in HIV infected patients by showing the abnormalities of FA and ADC,which may pro-vide evidence for early clinical diagnosis and treatment.