甲状腺功能亢进症患者SPECT脑血流灌注统计参数图分析
갑상선공능항진증환자SPECT뇌혈류관주통계삼수도분석
Cerebral blood flow and related factors in hyperthyroidism patients by SPELT imaging and statistical parametric mapping analysis
  • 万方数据
    中华核医学杂志 중화핵의학잡지
    CHINESE JOURNAL OF NUCLEAR MEDICINE
    2010年 1期 46-50 ,共5页

    修雁%石洪成%刘文官%陈雪芬%顾宇参%陈曙光%余浩军%虞一萍

    수안%석홍성%류문관%진설분%고우삼%진서광%여호군%우일평

    甲状腺功能亢进症%脑%局部血流%体层摄影术,发射型计算机,单光子%统计学%ECD 甲狀腺功能亢進癥%腦%跼部血流%體層攝影術,髮射型計算機,單光子%統計學%ECD
    갑상선공능항진증%뇌%국부혈류%체층섭영술,발사형계산궤,단광자%통계학%ECD
    Hyperthyroidism%Brain%Regional blood flow%Tomography,emission-computed,single-photon%Statistics%ECD
    目的 拟用SPECT脑血流灌注显像研究甲状腺功能亢进症(简称甲亢)患者脑血流改变模式,并分析可能相关因素.方法 年龄、性别、文化程度相匹配的25例甲亢患者和22名健康对照者于静脉注射~(99)Tc~m-双半胱乙酯(ECD)1110 MBq后30 min行静息SPECT脑灌注显像.应用统计参数图5.0软件(SPM5)对甲亢和对照者脑灌注图像进行体素对体素的团体t检验(P＜0.05,校正).应用基于Talairach图谱的脑功能自动提取法获取各个脑功能区的血流半定量值.血清FT_3、FT_4、高灵敏促甲状腺激素(sTSH)、甲状腺过氧化物酶抗体(TPOAb)、促甲状腺激素受体抗体(TRAb)浓度与脑灌注相关性应用单因素Pearson相关分析,病程与脑灌注相关性应用单因素Spearman相关分析.结果 甲亢患者大脑边缘系统、额叶血流灌注减低.边缘系统血流减低的部位主要包括海马钩回、两侧海马旁回(后内嗅皮质、后旁嗅皮质、海马旁皮质、前扣带回、右侧颞下回)和左侧下丘脑及尾状核体(P＜0.05,校正).额叶血流减低部位包括左侧前体感联合皮质、前运动皮质、额叶眼动区(t=5.87,P＜0.05,校正).甲亢患者左侧舌回、后扣带回血流灌注与FT3浓度呈负相关(r=-0.468,-0.417,P均＜0.05).左侧舌回、两侧颞下回、右侧顶上小叶血流与FT_4浓度呈负相关(r=-0.434,-0.418,-0.415,-0.459,P均＜0.05),左侧乳头体、左侧壳核血流与FT_4浓度呈正相关(r=0.419,0.412,P均＜0.05).左侧岛叶血流与sTSH呈负相关,右侧听觉联合皮质血流与sTSH呈正相关(r=-0.504,0.429,P均＜0.05).左侧颞中回、左侧角回血流与TBAb呈正相关(r=0.750,0.862,P均＜0.05),右侧丘脑、右侧下丘脑、左侧前核、左侧腹侧核血流与TRAb呈负相关(r=-0.691,-0.835,-0.713,-0.759,P均＜0.05);右侧前扣带回、右侧楔叶、右侧直回、右侧缘上回血流与TPOAb呈正相关(r=0.696,0.581,0.779,0.683,P均＜0.05).甲亢患者中央后回、颞回、左侧缘上回、听觉联合皮质血流与病程呈正相关(r=0.502,0.457,0.524,0.440,P均＜0.05).结论 甲亢患者边缘系统、额叶脑血流减低,并与甲状腺激素、自身免疫抗体水平及病程相关.
    목적 의용SPECT뇌혈류관주현상연구갑상선공능항진증(간칭갑항)환자뇌혈류개변모식,병분석가능상관인소.방법 년령、성별、문화정도상필배적25례갑항환자화22명건강대조자우정맥주사~(99)Tc~m-쌍반광을지(ECD)1110 MBq후30 min행정식SPECT뇌관주현상.응용통계삼수도5.0연건(SPM5)대갑항화대조자뇌관주도상진행체소대체소적단체t검험(P＜0.05,교정).응용기우Talairach도보적뇌공능자동제취법획취각개뇌공능구적혈류반정량치.혈청FT_3、FT_4、고령민촉갑상선격소(sTSH)、갑상선과양화물매항체(TPOAb)、촉갑상선격소수체항체(TRAb)농도여뇌관주상관성응용단인소Pearson상관분석,병정여뇌관주상관성응용단인소Spearman상관분석.결과 갑항환자대뇌변연계통、액협혈류관주감저.변연계통혈류감저적부위주요포괄해마구회、량측해마방회(후내후피질、후방후피질、해마방피질、전구대회、우측섭하회)화좌측하구뇌급미상핵체(P＜0.05,교정).액협혈류감저부위포괄좌측전체감연합피질、전운동피질、액협안동구(t=5.87,P＜0.05,교정).갑항환자좌측설회、후구대회혈류관주여FT3농도정부상관(r=-0.468,-0.417,P균＜0.05).좌측설회、량측섭하회、우측정상소협혈류여FT_4농도정부상관(r=-0.434,-0.418,-0.415,-0.459,P균＜0.05),좌측유두체、좌측각핵혈류여FT_4농도정정상관(r=0.419,0.412,P균＜0.05).좌측도협혈류여sTSH정부상관,우측은각연합피질혈류여sTSH정정상관(r=-0.504,0.429,P균＜0.05).좌측섭중회、좌측각회혈류여TBAb정정상관(r=0.750,0.862,P균＜0.05),우측구뇌、우측하구뇌、좌측전핵、좌측복측핵혈류여TRAb정부상관(r=-0.691,-0.835,-0.713,-0.759,P균＜0.05);우측전구대회、우측설협、우측직회、우측연상회혈류여TPOAb정정상관(r=0.696,0.581,0.779,0.683,P균＜0.05).갑항환자중앙후회、섭회、좌측연상회、은각연합피질혈류여병정정정상관(r=0.502,0.457,0.524,0.440,P균＜0.05).결론 갑항환자변연계통、액협뇌혈류감저,병여갑상선격소、자신면역항체수평급병정상관.
    Objective To investigate the cerebral blood flow (CBF) perfusion patterns and related factors in hyperthyroidism patients.Methods Twenty-five patients with hyperthyroidism and twenty-two healthy controls matched for age,sex,education were enrolled.~(99)Tc~m-ethylene cysteinate dimer (ECD) SPECT CBF perfusion imaging was performed at rest.Statistical parametric mapping 5.0 software (SPM5) was used and a statistical threshold of P＜0.05 (corrected) was applied for signifying changes of regional CBF (rCBF).The semiquantitative values of rCBF were extracted automatically by brain search 1.1 software and were correlated with concentrations of serum thyroid hormones(FT_3,FT_4),thyroid autoimmune antibodies:sensitive thyroid stimulating hormone(sTSH),thyroid peroxidase antibody (TPOAb) and TSH receptor antibody (TRAb) by Pearson analysis,with disease duration by Spearman analysis.Results rCBF was decreased significantly in limbic system and frontal lobe,including parahippocampal gyrus,uncus (posterior entorhinal cortex,posterior parolfactory cortex,parahippocampal cortex,anterior cingulate,right inferior temporal gyrus),left hypothalamus and caudate nucleus (P＜0.05,corrected).rCBF in left lingual gyrus,posterior cingulated was negatively correlated with concentration of FT_3(r=-0.468,-0.417,both P＜0.05).rCBF in left lingual gyrus,bilateral inferior temporal gyrus,right superior parietal lobe was negatively correlated with concentration of FT_4(r=-0.4M,-0.418,-0.415,-0.459,all P＜0.05),while that in left mammillary body and putamen was positively correlated with concentration of FT_4(r=0.419,0.412,both P＜0.05).rCBF in left insula was negatively correlated with concentration of sTSH,and right auditory associated cortex was positively correlated with concentration of sTSH(r=-0.504,0.429,both P＜0.05).rCBF in left middle temporal gyrus,left angular gyrus was positively correlated with concentration of TRAb while that in right thalamus,right hypothalamus,left anterior nucleus,left ventralis nucleus was negatively correlated with concentration of TRAb(r=0.750,0.862,-0.691,-0.835,-0.713,-0.759,all P＜0.05).rCBF in right anterior cingulate,right cuneus,right rectus gyrus,right superior marginal gyrus was positively correlated with concentration of TPOAb(r=0.696,0.581,0.779,0.683,all P＜0.05).rCBF in postcentral gyrus,temporal gyrus,left superior marginal gyrus and auditory associated cortex was positively correlated with disease duration(r=0.502,0.457,0.524,0.440,all P＜0.05).Conclusion Hypoperfusions in limbic system and fontal lobe were found in hyperthyroidism Patients,which might be associated with thyroid function and disesse duration.
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