| 张艳利,王天红,郭顺林,雷军强,王帅文,南江,王少彧,岳梦颖.弥散峰度成像预测急性一氧化碳中毒迟发脑病[J].中国医学影像技术,2020,36(2):215~219 |
| 弥散峰度成像预测急性一氧化碳中毒迟发脑病 |
| Diffusion kurtosis imaging in predicting delayed encephalopathy after acute carbon monoxide poisoning |
| 投稿时间：2019-06-09 修订日期：2019-08-10 |
| DOI：10.13929/j.issn.1003-3289.2020.02.011 |
| 中文关键词: 一氧化碳中毒 白质 磁共振成像 |
| 英文关键词:carbon monoxide poisoning white matter magnetic resonance imaging |
| 基金项目:甘肃省中医药管理局科研项目（GZK-2018-47）。 |
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| 中文摘要: |
| 目的 观察弥散峰度成像（DKI）预测急性一氧化碳中毒（ACOP）迟发性脑病（DE）的价值。方法 前瞻性收集ACOP患者，于其中毒后7天内行DKI扫描，获得平均峰度（MK）、轴向峰度（AK）及径向峰度（RK）图；手动于6个部位放置9个ROI，包括半卵圆中心（前部及后部）、胼胝体（膝、干及压部）、额叶、顶叶、颞叶及枕叶。随访3个月，分为DE组和非DE组进行观察。结果 与非DE组相比，DE组各ROI的MK、AK及RK值呈升高趋势；DE组半卵圆中心前部MK值和半卵圆中心前部及后部、胼胝体膝、额叶及顶叶AK值均明显高于非DE组（P均<0.05）；半卵圆中心前部AK值预测DE的AUC最大（0.78，P<0.01），95% CI为0.68~0.89.以AK值1.05为临界值，诊断敏感度81.82%（18/22），特异度60.38%（32/53），阳性预测值46.15%（18/39），阴性预测值88.89%（32/36），准确率66.67%（50/75）。结论 ACOP患者脑白质DKI参数值升高与DE关系密切，半卵圆中心前部AK值>1.05预示DE发生。 |
| 英文摘要: |
| Objective To investigate the value of diffusion kurtosis imaging (DKI) in predicting delayed encephalopathy (DE) after acute carbon monoxide poisoning (ACOP). Methods ACOP patients were prospectively enrolled. DKI scans were performed, and mean kurtosis (MK), axial kurtosis (AK) radial kurtosis (RK) were obtained within 7 days after ACOP. The parameters of 9 regions of interest (ROI) from 6 positions, including anterior and posterior semioval center, genu, trunk and splenium of corpus callosum,frontal, parietal, temporal and occipital lobe were manually placed. After 3 months' follow-up, the patients were divided into DE group and non-DE group. Results In DE group, the values of MK, AK and RK of all ROI were higher than those in non-DE group. MK values of anterior semioval center, AK of anterior and posterior semioval center, genu of corpus callosum,frontal and parietal lobe in DE group were higher than that in non-DE group (all P<0.05). AK value of anterior semioval center had the largest area under the ROC curve for predicting DE (0.78, P<0.01). Taken 1.05 as the cut-off value of AK, the sensitivity, specificity, positive predictive, negative predictive and accuracy was 81.82% (18/22), 60.38% (32/53), 46.15% (18/39), 88.89% (32/36) and 66.67% (50/75), respectively. Conclusion There are close relationships between the increase of white matter DKI parameters and the occurrence of DE in ACOP patients. AK value >1.05 in anterior semioval center indicates the occurrence of DE after ACOP. |
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