| 李飞,蒲伟,邢洁,赵鹏飞,杨正汉,王振常,李小帅.对比双侧听觉皮层脑血流量差异及其可能机制[J].中国医学影像技术,2026,42(5):682~686 |
| 对比双侧听觉皮层脑血流量差异及其可能机制 |
| Differences of cerebral blood flow in bilateral auditory cortex and possible mechanisms |
| 投稿时间：2025-02-18 修订日期：2025-07-28 |
| DOI：10.13929/j.issn.1003-3289.2026.05.006 |
| 中文关键词: 耳鸣 脑血流量 磁共振成像 |
| 英文关键词:tinnitus cerebral blood flow magnetic resonance imaging |
| 基金项目:国家自然科学基金(82202109)、北京市自然科学基金(7232335)。 |
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| 中文摘要: |
| 目的 基于3D伪连续动脉自旋标记(3D-pCASL)技术对比双侧听觉皮层脑血流量(CBF)差异及其可能机制。方法 回顾性分析39例主观性耳鸣(ST,ST组)、42例客观性耳鸣(OT,OT组)及43名健康对照(HC)者(HC组)的临床与影像学资料。基于3D-pCASL全脑灌注数据获得CBF图,通过ROI分析提取双侧初级听觉皮层(PAC)、次级听觉皮层(SAC)和听觉联合皮层(AAC)的标准化CBF并计算偏侧化指数。以年龄、性别为协变量,采用单因素协方差分析比较3组相同听觉皮层,以配对样本t检验分析组内左、右侧CBF差异;利用Spearman偏相关分析评估CBF与耳鸣严重程度[耳鸣致残量表(THI)评分]及病程的相关性。结果 3组间左侧PAC及SAC的标准化CBF差异均有统计学意义(P均＜0.05)。ST组左侧PAC、OT组左侧SAC的标准化CBF均高于HC组(P均＜0.05)。3组左侧PAC标准化CBF均高于右侧,而右侧SAC和AAC标准化CBF均高于左侧(P均＜0.05)。OT组左侧SAC标准化CBF与THI评分呈弱正相关(rs=0.373,P=0.015),ST组左侧PAC标准化CBF与耳鸣病程呈弱正相关(rs=0.355,P=0.026)。结论 全部受试者PAC的CBF均呈左侧优势、而SAC和AAC均呈右侧优势,表明其为听觉系统的固有生理特征,与患有耳鸣与否及耳鸣类型无关,而可能与双侧大脑半球听觉皮层的柱状结构和神经连接结构的固有差异有关。 |
| 英文摘要: |
| Objective To observe the differences of cerebral blood flow (CBF) in bilateral auditory cortex based on 3D-pseudo-continuous arterial spin labeling (3D-pCASL), and to analyze possible mechanisms. Methods Clinical and imaging data of 39 patients with subjective tinnitus (ST, ST group), 42 patients with objective tinnitus (OT, OT group) and 43 healthy controls (HC, HC group) were retrospectively analyzed. Whole brain perfusion scanning using 3D-pCASL was performed to obtain CBF images. Standardized CBF of bilateral primary auditory cortex (PAC), secondary auditory cortex (SAC) and auditory association cortex (AAC) were extracted based on ROI analysis, and the lateralization index was calculated. Using age and gender as covariates, one-way analysis of covariance was conducted to compare the differences of CBF in the same auditory cortex among 3 groups, and paired-sample t-test was used to analyze the differences of left and right side CBF within each group. Spearman partial correlation analysis was used to explore correlations of CBF with the severity of tinnitus (tinnitus handicap inventory[THI] score), as well as with disease duration. Results There were significant differences of standardized CBF of left PAC and left SAC among 3 groups (both P＜0.05). Standardized CBF of left PAC in ST group and of left SAC in OT group were both higher than those in HC group (both P＜0.05). Standardized CBF of PAC in the left side was higher than that in the right side in all 3 groups, while of SAC and AAC in the right side were higher than in the left side (all P＜0.05). Standardized CBF in the left SAC in OT group showed a weak positive correlation with THI scores (rs=0.373, P=0.015), while of the left PAC in ST group showed a weak positive correlation with duration of tinnitus (rs=0.355, P=0.026). Conclusion Left dominant of PAC and right dominant of SAC and AAC were observed in all subjects, indicating that these were the physiological characteristics of auditory system, not correlated with the presence or type of tinnitus, but might be associated with the innate differences of columnar structures and neural architecture of bilateral auditory cortex. |
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