| 李丹,卜岗,张明,王渊.基于DTI的三叉神经痛脑白质结构异常及其与临床特征的相关性[J].中国医学影像技术,2019,35(7):971~975 |
| 基于DTI的三叉神经痛脑白质结构异常及其与临床特征的相关性 |
| DTI based white matter abnormalities and correlation with clinical features of primary trigeminal neuralgia |
| 投稿时间：2019-01-14 修订日期：2019-05-01 |
| DOI：10.13929/j.1003-3289.201901090 |
| 中文关键词: 三叉神经痛 扩散张量成像 基于纤维束空间统计学 视觉模拟评分 |
| 英文关键词:trigeminal neuralgia diffusion tensor imaging tract-based spatial statistics visual analogue scale |
| 基金项目:陕西省自然科学基础研究计划面上项目（2018JM7026）、西安市科技计划项目、西安交通大学基本科研业务费专项科研项目（xjj2018272）。 |
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| 中文摘要: |
| 目的 采用基于纤维束的空间统计方法（TBSS）探讨原发性三叉神经痛（PTN）患者脑白质微结构异常。方法 对38例PTN患者（PTN组）和38名年龄、性别匹配的健康志愿者（对照组）行全脑DTI扫描，并用FSL软件进行分析，寻找FA值、平均扩散系数（MD）、径向扩散系数（RD）和轴向扩散系数（AD）存在组间统计学差异的脑区，并与视觉模拟评分（VAS）进行相关分析。结果 与对照组相比，PTN组胼胝体、放射冠、左侧上纵束、左侧下纵束及下额枕束FA值降低；且PTN组双侧丘脑后辐射、双侧内囊、双侧外囊、穹窿、右侧上纵束同时存在MD值和RD值升高，而AD升高脑区仅局限于双侧内囊前支、左侧内囊后支、双侧上放射冠和双侧上纵束。PTN患者左侧上纵束FA值与VAS呈负相关（r=-0.502，P=0.001），左侧上纵束MD值与VAS评分呈正相关（r=0.437，P=0.006）。结论 丘脑、内囊MD值和RD值同向升高而不伴FA值降低可能是PTN的相对特征性DTI表现；左侧上纵束FA值和MD值对评估PTN患者疼痛水平有参考价值。 |
| 英文摘要: |
| Objective To explore the microstructure abnormalities of white matter (WM) throughout the brain in patients with primary trigeminal neuralgia (PTN) using tract-based spatial statistics (TBSS). Methods Whole brain DTI scanning was performed on 38 PTN patients and 38 age and sex matched healthy volunteers. DTI data were processed with FSL software package. The different brain regions of FA, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated, and then the correlation between these parameters and visual analogue scale (VAS) were evaluated in PTN patients. Results Compared with the controls, widespread decrease of FA value in corpus callosum, coronal radiata, left superior longitudinal fasciculus, left inferior longitudinal fasciculus and inferior frontal-occipital fasciculus were demonstrated in PTN patients. Besides these regions, the elevated MD and RD values were also distributed extensively in posterior thalamic radiation, internal capsule, external capsule, fornix and right superior longitudinal fasciculus. Increased AD value was found in bilateral anterior limbs of internal capsule, left posterior limb of internal capsule, bilateral superior coronal radiata and superior longitudinal fasciculus. In addition, the mean VAS was negatively correlated with FA value (r=-0.502, P=0.001) and positively associated with MD value (r=0.437, P=0.006) in left superior longitudinal fasciculus in PTN patients. Conclusion Elevation of MD and RD without FA alterations in thalamus and internal capsule may be relatively characteristic in PTN patient, and FA and MD values extracted from left superior longitudinal fasciculus may become alternative indicators for assessing facial pain in PTN patients. |
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