| 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的价值[J].中国医学影像技术,2020,36(2): |
| 弥散峰度成像预测急性一氧化碳中毒迟发脑病的价值 |
| The value of predicting the delayed neuropsychiatric sequelae after acute carbon monoxide poisoning with diffusion kurtosis imaging |
| 投稿时间：2019-06-09 修订日期：2020-02-19 |
| DOI： |
| 中文关键词: 一氧化碳中毒 脑白质 迟发脑病 弥散峰度成像 磁共振成像 |
| 英文关键词:Carbon monoxide poisoning White matter Delayed neuropsychiatric sequelae Magnetic resonance imaging Diffusion kurtosis imaging |
| 基金项目:中医针刺联合高压氧治疗一氧化碳中毒的疗效观察及功能磁共振成像研究 |
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| 中文摘要: |
| [摘要] 目的 探讨弥散峰度成像（DKI）对急性一氧化碳中毒（ACOP）迟发脑病（DNS）预测的应用价值。 方法 前瞻性收集2016年11月至2019年2月就诊于兰州大学第一医院ACOP患者，于中毒后7天内行DKI扫描并获得平均峰度（MK）、轴向峰度（AK）及径向峰度（RK）图，手动放置6个部位9个感兴趣区（ROI）：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月后将其分为DNS组和非DNS组。结果 与非DNS组相比，DNS组各感兴趣区MK、AK及RK值呈升高趋势；DNS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DNS组（P＜0.05）；半卵圆中心前部AK值预测DNS的接受者操作特征（ROC）曲线下面积值最大（0.78，P=0.00），95%可信区间0.68～0.89，以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），准确度66.67%（50/75）。结论 ACOP患者脑白质峰度参数值升高与DNS的发生关系密切，半卵圆中心前部AK值大于1.05预示DNS发生。 |
| 英文摘要: |
| [Abstract] Objective To investigate the value of predicting delayed neuropsychiatric sequelae (DNS) after acute carbon monoxide poisoning (ACOP) with diffusion kurtosis imaging (DKI). Methods The patients diagnosed as ACOP were prospectively enrolled in this study. DKI scans were performed within 7 days after ACOP. After 3 months of follows-up, the patients were divided into DNS group and non-DNS group. The parameters of 9 regions of interest (ROIs) were measured on the DKI-derived maps. Results In the DNS group, the values of mean diffusion kurtosis (MK), axial kurtosis (AK) radial kurtosis (RK) of all ROIs were higher than those in the non-DNS group. Among which，the MK values of anterior semioval center, AK of anterior and posterior semioval center, genu of corpus callosum，frontal and parietal lobe were significantly difference between the two groups (P<0.05). The AK value of anterior semioval center had the largest area under the ROC curve of predicting DNS (0.78, P=0.00), the cut-off value of AK was 1.05, the sensitivity, specificity, positive predictive, negative predictive and accuracy were 81.82% (18/22), 60.38% (32/53), 46.15% (18/39), 88.89% (32/36), 66.67% (50/75) respectively. Conclusion DKI is valuable in quantitatively predicting the DNS occurrence after CO poisoning. |
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