CAJ | 학술논문

目的探讨磁共振(MR)扩散张量成像(DTI)对急性CO中毒迟发性脑病(DEACMP)患者脑白质损害及认知功能障碍的诊断价值.方法应用1.5 T MR对13例DEACMP患者和13例年龄、性别相匹配正常志愿者(对照组)行DTI检查.由两名影像科医师应用双盲法测量DT1图像上16处不同脑白质区的平均扩散系数值(ADC)和各向异性分数(FA)值,另一名神经科医师采用蒙特利尔认知评估量表(MoCA)双盲法评价DEACMP患者的认知功能.定量分析DEACMP患者ADC和FA值变化及其与认知功能障碍的相关性.结果 DEACMP患者所有感兴趣区脑白质ADC值均较对照组明显增高(P＜0.05).除双侧视辐射、内囊前、后肢外,DEACMP患者其余脑白质感兴趣区FA值均较对照组明显减低(P＜0.05).DEACMP患者的MoCA评分与双额底(r左=0.736,P=0.011;r右=0.762,P=0.003)、双颞叶白质(r左=0.605,P=0.016;r右=0.559,P=0.021)及所有感兴趣区总平均FA值(r均=0.688,P=0.001)呈正相关,与双额底ADC值(r左=-0.674,P=0.007;r右=-0.681,P=0.019)呈负相关.结论 DTI可以定量评价DEACMP患者脑白质微观结构的损伤,反映认知功能障碍程度,对了解DEACMP的病理改变及发病机制具有重要意义.
목적 탐토자공진(MR)확산장량성상(DTI)대급성CO중독지발성뇌병(DEACMP)환자뇌백질손해급인지공능장애적진단개치.방법 응용1.5 T MR대13례DEACMP환자화13례년령、성별상필배정상지원자(대조조)행DTI검사.유량명영상과의사응용쌍맹법측량DT1도상상16처불동뇌백질구적평균확산계수치(ADC)화각향이성분수(FA)치,령일명신경과의사채용몽특리이인지평고량표(MoCA)쌍맹법평개DEACMP환자적인지공능.정량분석DEACMP환자ADC화FA치변화급기여인지공능장애적상관성.결과 DEACMP환자소유감흥취구뇌백질ADC치균교대조조명현증고(P＜0.05).제쌍측시복사、내낭전、후지외,DEACMP환자기여뇌백질감흥취구FA치균교대조조명현감저(P＜0.05).DEACMP환자적MoCA평분여쌍액저(r좌=0.736,P=0.011;r우=0.762,P=0.003)、쌍섭협백질(r좌=0.605,P=0.016;r우=0.559,P=0.021)급소유감흥취구총평균FA치(r균=0.688,P=0.001)정정상관,여쌍액저ADC치(r좌=-0.674,P=0.007;r우=-0.681,P=0.019)정부상관.결론 DTI가이정량평개DEACMP환자뇌백질미관결구적손상,반영인지공능장애정도,대료해DEACMP적병리개변급발병궤제구유중요의의.
Objective To explore the diagnostic value of magnetic resonance (MR) diffusion tensor imaging (DTI) in detecting brain white matter (WM) damage of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and evaluating their cognitive dysfunction.Methods Thirteen patients with DEACMP and thirteen age-and sex-matched volunteers underwent DTI using 1.5T MR scanner.FA and ADC values of 16 WM regions of interests (ROIs) were measured on DTI by two experienced radiologists independently with double blind methods,cognitive functions were evaluated by another experienced neurologist blinded to patient's medical history using the Montreal cognitive assessment (MoCA).ADC and FA values in DEACMP patients,and their correlations with cognitive dysfunction were analyzed.Results ADC values of DEACMP patients increased significantly in all ROIs (P＜0.05) in comparison with the corresponding ROIs of healthy controls,whereas FA values were significantly decreased in all ROIs (P＜0.05) in comparison with that in controls except the bilateral optic radiations,anterior and posterior internal capsules.MoCA scores were positively correlated with FA values of bilateral lower frontal (rL=0.736,P=0.011 ; rR=0.762,P=0.003) lobe,temporal lobe (rL=0.605,P=0.016 ; rR=0.559,P=0.021) and total average WM (rA=0.688,P=0.001),however it inversely correlated with ADC values of bilateral lower frontal WM (rL=--0.674,P=0.007;rR=-0.681,P=0.019).Conclusion DTI can quantitatively reveal WM microstructure damage of DEACMP patients,indicate the severity of cognitive dysfunctions,and provide important information for pathogenesis and pathological study for DEACMP.