CAJ | 학술논문

目的应用磁化传递成像(MTI)研究原发性青光眼患者双侧视放射、视皮质的异常,探讨青光眼性损伤对后视路的影响.方法选取20例常规颅脑MR检查无异常的原发性青光眼患者(青光眼组)及31名正常志愿者(对照组)行MTI检查,采用扰相梯度回波序列(SPGR)成像,分别于施加磁化传递饱和脉冲前后进行扫描.将扫描图像进行后处理分析,测量双侧视放射及视皮质的磁化传递率(MTR).组间各部位MTR值的比较采用两样本t检验(方差不齐则采用Satterthwaite近似t检验).结果青光眼组左、右两侧视放射的MTR值分别为(32.8±2.2)％、(32.7±2.0)％,对照组相应部位MTR值分别为(34.6±1.4)％、(34.8±1.3)％,青光眼组低于对照组,差异有统计学意义(左侧t=3.284,右侧t=4.040；P值均＜0.01).青光眼组左、右两侧视皮质的MTR值分别为(30.1±2.0)％、(30.8±1.8)％,对照组相应部位MTR值分别为(32.3±1.2)％、(32.4±1.2)％,青光眼组低于对照组,差异也有统计学意义(左侧t =4.319,右侧t=3.445；P值均＜0.01).结论青光眼患者后视路发生了潜在神经病理学变化,提示青光眼是累及全视路的病变.MTI能在肉眼可见的影像学改变之前提供微观病理方面的信息,是活体人青光眼视觉通路跨突触损害研究的有用方法,也为青光眼临床诊治及评估预后提供了新的思路.
목적 응용자화전체성상(MTI)연구원발성청광안환자쌍측시방사、시피질적이상,탐토청광안성손상대후시로적영향.방법 선취20례상규로뇌MR검사무이상적원발성청광안환자(청광안조)급31명정상지원자(대조조)행MTI검사,채용우상제도회파서렬(SPGR)성상,분별우시가자화전체포화맥충전후진행소묘.장소묘도상진행후처리분석,측량쌍측시방사급시피질적자화전체솔(MTR).조간각부위MTR치적비교채용량양본t검험(방차불제칙채용Satterthwaite근사t검험).결과 청광안조좌、우량측시방사적MTR치분별위(32.8±2.2)％、(32.7±2.0)％,대조조상응부위MTR치분별위(34.6±1.4)％、(34.8±1.3)％,청광안조저우대조조,차이유통계학의의(좌측t=3.284,우측t=4.040；P치균＜0.01).청광안조좌、우량측시피질적MTR치분별위(30.1±2.0)％、(30.8±1.8)％,대조조상응부위MTR치분별위(32.3±1.2)％、(32.4±1.2)％,청광안조저우대조조,차이야유통계학의의(좌측t =4.319,우측t=3.445；P치균＜0.01).결론 청광안환자후시로발생료잠재신경병이학변화,제시청광안시루급전시로적병변.MTI능재육안가견적영상학개변지전제공미관병리방면적신식,시활체인청광안시각통로과돌촉손해연구적유용방법,야위청광안림상진치급평고예후제공료신적사로.
Objective To analyse the changes in bilateral optic radiation and visual cortex in patients with primary glaucoma detected by magnetization transfer imaging ( MTI ),and try to explore the influence of the disease on posterior visual pathway.Methods MTI was performed in 20 patients with primary glaucoma with normal signal on conventional magnetic resonance imaging (MRI).The same scanning was performed in 31matched healthy controls.MTI was obtained using spoiled gradient recalled acquisition sequence (SPGR).Magnetization transfer ratio ( MTR ) of bilateral optic radiation and visual cortex was measured after post-processing.The MTR value differences of the same area between two groups were compared by independent-sample t test or Satterthwaite t test if variances were not equality.Result The MTR value in the left and right optic radiation were ( 32.8 ± 2.2 ) ％ and ( 32.7 ± 2.0 ) ％ in the glaucoma group,(34.6 ± 1.4 )％ and (34.8 ± 1.3 )％ in the control group.There was a statistically significant difference between the two groups (left t =3.284,right t =4.040 ;P ＜ 0.01).The MTR value of the left and right visual cortex were ( 30.1± 2.0 ) ％ and ( 30.8 ± 1.8 ) ％ in the glaucoma goup,and (32.3 ± 1.2 )％ and (32.4 ± 1.2 )％ in the control group.Statistically significant difference was found between the two groups ( left t =4.319,right t =3.445 ;P ＜ 0.01).Conclusions Potential neuropathology changes occurring in the posterior visual pathway of patients with glaucoma indicate that the whole visual pathway may be involved by glaucoma.The micro physiological changes can be detected by MTI which can not be found by conventional MRI.It is a useful method of studying trans-synaptic damage of visual pathway n vivo glaucoma which provides more information for guiding the clinic diagnosis,cure and prognosis of glaucoma.