常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析

doi:10.3969/j.issn.1006-7795.2016.04.008

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (4): 454-459.doi: 10.3969/j.issn.1006-7795.2016.04.008

• 感染与炎性反应放射学 • 上一篇下一篇

常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析

李瑞利¹, 米海峰², 李宏军¹, 任美吉^1,2, 赵晶^1,2, 员达^1,2, 王伟^1,2

1. 首都医科大学附属北京佑安医院放射科, 北京 100069;
2. 首都医科大学附属北京同仁医院放射科, 北京 100730

收稿日期:2016-06-03 出版日期:2016-08-21 发布日期:2016-07-18
通讯作者: 李宏军 E-mail:lihongjun00113@126.com
基金资助:
国家自然科学基金（8157070365），北京市属医院科研培育项目（PX2016036），北京市医院管理局临床医学发展专项经费资助（扬帆计划）（ZYLX201511）。

Diffusion tensor imaging in brain white matter of AIDS patients with normal appearance on conventional MRI by using tract-based spatial statistics

Li Ruili¹, Mi Haifeng², Li Hongjun¹, Ren Meiji^1,2, Zhao Jing^1,2, Yuan Da^1,2, Wang Wei^1,2

1. Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China;
2. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Received:2016-06-03 Online:2016-08-21 Published:2016-07-18
Supported by:
This study was supported by National Natural Science Foundation of China(8157070365),Beijing Municipal Administration of Hospitals Incubating Program(PX2016036),Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding(ZYLX201511).

摘要/Abstract

摘要： 目的采用弥散张量成像（diffusion tensor imaging，DTI）及基于纤维束追踪的空间统计（track-based spatial statistics，TBSS）观察常规磁共振成像（magnetic resonance imaging，MRI）表现正常的获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS）患者脑白质微结构变化。方法对性别、年龄相匹配的22例常规MRI表现正常的AIDS患者（患者组）及23例健康志愿者（对照组）行DTI检查，采用TBSS分析所有受试者脑白质DTI的各相关参数指标的改变，包括各向异性分数（fractional anisotropy，FA）、平均弥散度（mean diffusivity，MD）、组间轴向弥散（axial diffusivity，AD）值和径向弥散（radial diffusivity，RD）值，进一步提取组间差异有统计学意义脑区的患者组的DTI参数值并与CD4⁺进行相关性分析。结果与正常对照组相比，患者组多个脑区MD值升高，主要包括胼胝体膝部、胼胝体体部、胼胝体压部、双侧前辐射冠、上辐射冠、后辐射冠、上纵束、左侧内囊前肢、外囊和扣带回（P<0.05，TFCE及FWE校正）。患者组多个脑区AD值升高，主要包括胼胝体膝部、胼胝体体部、胼胝体压部、双侧前辐射冠、上辐射冠、后辐射冠、上纵束、内囊前肢、外囊和扣带回（P<0.05，TFCE及FWE校正）。左侧白质改变多于右侧，胼胝体及双侧前辐射冠是损伤范围较大的脑区。两组各脑区FA值和RD值差异均无统计学意义（P>0.05，TFCE及FWE校正）。与对照组相比，患者组中差异有统计学意义脑区的MD值与患者CD4计数呈负相关（r=-0.435，P=0.043）。结论常规MRI表现正常的AIDS患者大脑多个区域白质微结构损伤，其病理特征可能是轴索异常改变，损伤区域主要涉及记忆、智能、认知控制等相关脑区。DTI和TBSS技术可以敏感地发现常规MRI表现正常的AIDS患者脑损伤白质微观结构变化。

关键词: 艾滋病, 弥散张量成像, 脑白质, 基于纤维束追踪空间统计分析

Abstract: Objective To analyze the microscopic changes of white matter (WM) in acquired immunodeficiency syndrome (AIDS) patients with normal appearance on conventional magnetic resonance imaging (MRI) by diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS). Methods Twenty-two acquired immunodeficiency syndrome (AIDS) patients with normal appearance on conventional MRI (patient group) and 23 healthy volunteers (control group) with matched age and sex were recruited. Siemens 3.0T magnetic resonance scanner was used for DTI data acquisition. DTI parameters of WM, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were compared between the two groups with TBSS. DTI indices with significant difference were further extracted from AIDS patients, correlation analysis was used between DTI indices and CD4⁺ T cell counts. Results Compared with the control group, significantly increased MD were found in several white matter regions including the genu of corpus callosum (GCC), body of corpus callosum (BCC), splenium of corpus callosum (SCC), bilateral anterior corona radiation (ACR), superior corona radiation (SCR), posterior corona radiation (PCR), the left anterior limb of internal capsule (ALIC), external capsule (EC) and cingulate gyrus (CIN-CG) in patient group (P<0.05, corrected by TFEC and FWE); Significantly increased AD were found in the GCC, BCC, SCC, bilateral ACR, SCR, PCR, ALIC, EC and CIN-CG in patient group (P<0.05, corrected by TFEC and FWE). There was more white matter impairment in left hemisphere than that in the right. Corpus callosum and bilateral corona radiata were the larger brain damage regions. The differences of FA values and RD values in every region were not significant between the two groups (P>0.05, corrected by TFEC and FWE). In patient group, significantly negative correlation was found between MD values and CD4⁺ T cell counts in significant clusters (r=-0.457, P=0.034). Conclusion White matter integrity was significantly reduced in extensive regions among AIDS patients with normal appearance on conventional MRI. The pathological features may be the abnormalities in axonal. The involved brain areas mainly related to memory, intelligence and cognitive controls. DTI and TBSS analysis can sensitively discover the white matter microstructure injury in AIDS patients with normal appearance on conventional MRI.

Key words: acquired immunodeficiency syndrome (AIDS), diffusion tensor imaging, white matter, tract-based spatial statistics

中图分类号:

R512.91

李瑞利, 米海峰, 李宏军, 任美吉, 赵晶, 员达, 王伟. 常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析[J]. 首都医科大学学报, 2016, 37(4): 454-459.

Li Ruili, Mi Haifeng, Li Hongjun, Ren Meiji, Zhao Jing, Yuan Da, Wang Wei. Diffusion tensor imaging in brain white matter of AIDS patients with normal appearance on conventional MRI by using tract-based spatial statistics[J]. Journal of Capital Medical University, 2016, 37(4): 454-459.

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常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析

Diffusion tensor imaging in brain white matter of AIDS patients with normal appearance on conventional MRI by using tract-based spatial statistics

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