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中华介入放射学电子杂志 ›› 2017, Vol. 05 ›› Issue (03) : 189 -193. doi: 10.3877/cma.j.issn.2095-5782.2017.03.016

所属专题： 文献；

医学影像

DTI检测阿尔茨海默病脑白质的改变
任津瑶1, 龙淼淼2, 祁吉3, 倪红艳3,†()   
  1. 1. 300222　天津医学高等专科学校
    2. 300192　天津市第一中心医院放射科
  • 收稿日期:2017-06-01 出版日期:2017-08-01
  • 通信作者: 倪红艳

Diffusion tensor imaging detection of white matter changes in Alzheimer's disease

Jinyao Ren1, Miaomiao Long2, Ji Qi3, Hongyan Ni3,†()   

  1. 1. Tianjin Medical College, Tianjin 300222, China
    3. Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China
  • Received:2017-06-01 Published:2017-08-01
  • Corresponding author: Hongyan Ni
  • About author:
    Corresponding author: Email:
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引用本文：

任津瑶, 龙淼淼, 祁吉, 倪红艳. DTI检测阿尔茨海默病脑白质的改变[J/OL]. 中华介入放射学电子杂志, 2017, 05(03): 189-193.

Jinyao Ren, Miaomiao Long, Ji Qi, Hongyan Ni. Diffusion tensor imaging detection of white matter changes in Alzheimer's disease[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(03): 189-193.

目的：

应用磁共振弥散张量成像（DTI）技术评价阿尔茨海默病（AD）患者脑白质的改变，分析部分各向异性（FA）和局域各向异性（GA）参数对AD患者脑白质损伤的诊断效率。

方法：

选取2014年8月—2015年8月确诊的AD患者12例（AD组），16例认知正常的健康老年志愿者为对照组，进行MRI常规扫描和DTI检查，测量上纵束、扣带束、胼胝体、内囊、额叶、顶叶、颞叶、枕叶脑白质的FA、GA值。应用ROC曲线评价FA、GA参数检出AD患者脑白质损伤的诊断效率。

结果：

与对照组比较，AD组的扣带束后部FA、GA值降低；上纵束FA、GA值降低；顶叶白质FA、GA降低；额叶白质GA值降低；颞叶白质GA值降低；胼胝体压部GA降低，差异均有统计学意义。ROC曲线评价AD患者扣带束后部、上纵束、顶叶GA值曲线下面积较FA大,顶叶GA值对于AD患者脑白质损伤具有较高的诊断效率。

结论：

AD患者表现为选择性脑白质域性损害，扣带束后部、上纵束、胼胝体压部、额叶、颞叶、顶叶皮层下脑白质损伤，GA诊断AD病患者脑白质异常的效率比FA更佳。

关键词: 磁共振成像, 扩散张量成像, 阿尔茨海默病, 脑白质
Objective:

To evaluate the changes of white matter in Alzheimer's disease(AD) patients by Magnetic resonance diffusion tensor imaging (DTI) and to analyze the diagnostic value of Fractional anisotropy (FA) and Geodesic anisotropy (GA) in detecting white matter abnormalities in AD patients.

Methods:

MRI routine scan and DTI were performed in 12 AD patients who were diagnosed from August 2014 to August 2015. 16 cognitively normal (NC) healthy elderly volunteers were enrolled, as control group, to this study. The FA and GA of superior longitudinal fasciculus, Cingulate, corpus callosum, internal capsule, frontal lobe, parietal lobe, temporal lobe and occipital lobe white matter were measured. The ROC curve was applied to analyze Fractional anisotropy (FA) and Geodesic anisotropy (GA) parameters to determine the diagnostic value in detecting white matter abnormalities in patients with AD.

Results:

Compared to the control group, the FA and GA values in the posterior cingulate were decreased, the FA and GA values of the superior longitudinal fasciculus were decreased, the FA and GA of the white matter in the parietal lobe were decreased, the GA value of the white matter in the frontal lobe was decreased, the GA value of the white matter in temporal lobe was decreased and the GA value of the splenium of corpus callosum was decreased. The differences were statistically significant. The area under the ROC curve was more than 0.700, which was larger than that of FA.

Conclusion:

AD patients usuaug show selective and regional damage in the posterior cingulated and the damage in superior longitudinal fasciculus, splenium of corpus callosum, frontal lobe, temporal lobe, parietal cortex and subcortical white matter lesions. The diagnostic value of GA in detection of white matter abnormalities in patients with AD was superior to FA.

Key words: Magnetic resonance Imaging, Diffusion tensor imaging, Alzheimer’s disease, White matter
图1 胼胝体膝部、双侧扣带束前部FA、GA图及ROI
图2 胼胝体体部、双侧上纵束FA、GA图及ROI
图3 胼胝体压部、双侧扣带束后部FA、GA图及ROI
图4 双侧内囊前、后肢FA、GA图及ROI
图5 双侧额叶白质FA、GA图及ROI
图6 双侧颞叶白质FA、GA图及ROI
图7 双侧顶叶白质FA、GA图及ROI
图8 双侧枕叶白质FA、GA图及ROI
表1 AD组与NC组的FA值比较（±s）
组别 例数 胼胝体膝部 胼胝体体部 胼胝体压部 扣带束前部
AD组 12 0.874±0.066 0.923±0.029 0.929±0.037 0.692±0.084
NC组 16 0.886±0.065 0.922±0.025 0.945±0.346 0.732±0.034
t值 ? -0.448 0.099. -1.107 -1.728
P值 ? 0.658 0.922 0.280 0.096
组别 例数 扣带束后部 上纵束 内囊前肢 内囊后肢
AD组 12 0.593±0.096 0.653±0.039 0.683±0.141 0.797±0.077
NC组 16 0.675±0.106 0.694±0.064 0.688±0.068 0.806±0.066
t值 ? -2.112 -2.119 0.126 -0.292
P值 ? 0.045 0.044 0.901 0.773
组别 例数 额叶白质 颞叶白质 顶叶白质 枕叶白质
AD组 12 0.442±0.082 0.610±0.040 0.542±0.137 0.529±0.079
NC组 16 0.472±0.073 0.645±0.067 0.671±0.099 0.522±0.078
t值 ? -1.012 -1.671 -2.770 -0.256
P值 ? 0.323 0.132 0.012 0.800
表2 AD组与NC组的GA值比较（±s）
组别 例数 胼胝体膝部 胼胝体体部 胼胝体压部 扣带束前部
AD组 12 2.322±0.482 2.677±0.350 2.739±0.329 1.344±0.362
NC组 16 2.463±0.613 2.694±0.321 3.078±0.464 1.555±0.258
t值 ? -0.681 -0.126 -2.257 -1.718
P值 ? 0.502 0.901 0.033 0.102
组别 例数 扣带束后部 上纵束 内囊前肢 内囊后肢
AD组 12 1.155±0.258 1.289±0.171 1.583±0.655 1.814±0.355
NC组 16 1.502±0.379 1.543±0.283 1.419±0.289 1.904±0.336
t值 ? -2.881 -2.942 0.892 -0.685
P值 ? 0.008 0.007 0.381 0.500
组别 例数 额叶白质 颞叶白质 顶叶白质 枕叶白质
AD组 12 0.664±0.153 1.098±0.128 0.872±0.202 0.922±0.185
NC组 16 0.826±0.199 1.306±0.225 1.178±0.209 0.893±0.187
t值 ? -2.430 -2.858 -3.906 0.420
P值 ? 0.022 0.008 0.001 0.678
表3 各部位FA、GA值对AD患者脑白质变化的诊断效率
参数 诊断临界值 曲线下面积
扣带束后部FA 0.601 0.678
扣带束后部GA 1.129 0.745
上纵束FA 0.685 0.703
上纵束GA 1.283 0.766
顶叶FA 0.547 0.776
顶叶GA 0.901 0.865
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