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T2、FLair,DTI及全脑3D-T1WI。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,P<0.005。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。

Research of gray and white matter for patients with COPD at early stage by VBM and DTI

Objective To study the gray matter and white matter for patients with COPD at early stage by VBM and DTI.Methods 30 case of COPD and normal individuals were selected in this work.All enrolled subjects were subjected to DTI and high resolution of 3D-T1 serial on whole brain by PHILIPS 3.0 Tesla MR.VBM8 was used to obtain the gray matter mapping base on Matlab2013b.Long contact fibers were tracked by anatomy,arcuate fibers were seeded by the result of VBM mapping.FA and ADC value were measured by Philips work station.General data,FA and ADC materials were statistically analyzed with t-test in SPSS 17.0.Results Compared with the normal,VBM showed that gray matters of COPD were existed multiple active regions,including temporal gyrus(R),frontal orbit gyrus(R),parahippocampal gyrus(R),temporal pole(R),bilateral caudate nucleus,bilateral premotor cortex,supramarginal gyrus(L),and insula(R).FA value was declined on bilateral caudate nucleus,insula(R),bilateral corticospinal,cingulum(L),and Hook beam(L)(P<0.05).Conclusion The results present that COPD has changed in cerebral micro structure,but common MRI was normal.VBM and DTI can find the early change of brain micro-structure,which has significance to clinic diagnosis of this disorder.