弥散峰度成像对儿童阻塞性睡眠呼吸暂停综合征脑微结构变化的研究

doi:10.3969/j.issn.1006-7795.2018.02.005

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (2): 178-184.doi: 10.3969/j.issn.1006-7795.2018.02.005

• 影像新技术的临床与科研应用 • 上一篇下一篇

弥散峰度成像对儿童阻塞性睡眠呼吸暂停综合征脑微结构变化的研究

李文风¹, 文宏伟², 刘玥¹, 彭芸¹, 程华¹, 李宏彬³, 邰隽³

1. 首都医科大学附属北京儿童医院放射科国家儿童医学中心, 北京 100045;
2. 西南大学心理部, 重庆 400715;
3. 首都医科大学附属北京儿童医院耳鼻喉科国家儿童医学中心, 北京 100045

收稿日期:2018-02-27 出版日期:2018-03-21 发布日期:2018-04-14
通讯作者: 刘玥 E-mail:wangzhiqun@126.com
基金资助:
国家自然科学基金（81571648）。

Microstructural changes of white matter in obstructive sleep apnea syndrome on diffusional kurtosis imaging study

Li Wenfeng¹, Wen Hongwei², Liu Yue¹, Peng Yun¹, Cheng Hua¹, Li Hongbin³, Tai Jun³

1. Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China;
2. Department of Psychology, Southwest University, Chongqing 400715, China;
3. Otolaryngology-Head and Neck Surgery Department, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China

Received:2018-02-27 Online:2018-03-21 Published:2018-04-14
Supported by:
This study was supported by National Natural Science Foundation of China(81571648).

摘要/Abstract

摘要： 目的分析阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）患者脑微观结构的改变，探索OSAS患者认知功能下降的神经生理。方法对19例OSAS患者、23例正常对照组使用美国GE Medical Systems Discovery MR750 3.0T磁共振仪进行磁共振弥散峰度成像（diffusional kurtosis imaging，DKI）扫描，采用FSL软件对两组被试者进行基于纤维束空间统计学（tract-based spatial statistics，TBSS）分析和与临床参数的相关性分析。结果与正常对照组比较，OSAS患儿在右侧内囊前肢、右侧丘脑辐射、穹窿、胼胝体部分各向异性（fractional anisotropy，FA）值下降，在左后放射冠、右上纵行纤维束、右侧外囊、右侧内囊前肢、胼胝体压部峰度部分各向异性（kurtosis fractional anisotropy，KFA）值下降。右侧内囊前肢、左顶叶的KFA值与最低血样饱和度（lowest oxygen saturation，LSaO₂）呈正相关，胼胝体压部、右后放射冠、左侧中央后回、左前顶叶DKI参数值FA、KFA与血氧饱和度<90%所占比例、低通气指数呈负相关。结论 OSAS患者在多个脑区KFA值存在异常，且与缺氧存在关系，可能是OSAS患者认知功能下降的机制。

关键词: 阻塞性睡眠呼吸暂停综合征, 基于纤维束的空间统计学方法, 弥散峰度成像, 儿童

Abstract: Objective To analyze the microstructural changes of white matter (WM) in obstructive sleep apnea syndrome (OSAS), and to explore neurophysiological mechanisms of cognitive impairment in patients with OSAS. Methods We used tract-based spatial statistics (TBSS) analysis to compare diffusion and kurtosis parameters in 19 OSAS children and 23 age and gender matched healthy children. Results Compared to healthy controls, the diffusion parameter fractional anisotropy (FA) decreased in WM regions (anterior limb of internal capsule, anterior thalamic radiation, fornix, inferior longitudinal fasciculus and corpus callosum) with coherent fiber arrangement, while the kurtosis parameter kurtosis fractional anisotropy (KFA) decreased in WM regions (superior longitudinal fasciculus and posterior corona radiata) with complex fiber arrangement. The two parameters were sensitive to reveal abnormality of WM in OSAS children. There are multiple abnormal brain lobes in OSAS patients. The KFA values in the right forelimb of internal capsule and the left parietal lobe were positively correlated with lowest oxygen saturation (LSaO₂). The values FA, KFA of DKI parameters in the corpus callosum, right posterior coronaries, left post central and left anterior parietal lobes were negatively correlated with SaO₂ <90% and hypoventilation index. Conclusion The abnormal KFA value existed in multiple brain lobes in OSAS patients, which showed significant positive correlations with hypoxia, which may be mechanism of cognitive impairment for OSAS children.

Key words: obstructive sleep apnea syndrome, tract-based spatial statistics, diffusional kurtosis imaging, children

中图分类号:

R445

李文风, 文宏伟, 刘玥, 彭芸, 程华, 李宏彬, 邰隽. 弥散峰度成像对儿童阻塞性睡眠呼吸暂停综合征脑微结构变化的研究[J]. 首都医科大学学报, 2018, 39(2): 178-184.

Li Wenfeng, Wen Hongwei, Liu Yue, Peng Yun, Cheng Hua, Li Hongbin, Tai Jun. Microstructural changes of white matter in obstructive sleep apnea syndrome on diffusional kurtosis imaging study[J]. Journal of Capital Medical University, 2018, 39(2): 178-184.

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弥散峰度成像对儿童阻塞性睡眠呼吸暂停综合征脑微结构变化的研究

Microstructural changes of white matter in obstructive sleep apnea syndrome on diffusional kurtosis imaging study

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