终末期肾病患者的广泛脑白质改变：一项基于体素的弥散张量成像研究。
Widespread white matter alterations in patients with end-stage renal disease: a voxelwise diffusion tensor imaging study.
机构信息
Departments of Medical Imaging and Radiological Sciences, College of Health Sciences;
出版信息
AJNR Am J Neuroradiol. 2013 Oct;34(10):1945-51. doi: 10.3174/ajnr.A3511. Epub 2013 Jun 20.
BACKGROUND AND PURPOSE
ESRD results in excessive accumulation of urea and toxic metabolites. Hemodialysis is usually performed to maintain health in patients with ESRD; however, it may cause silent white matter alterations in the earlier stages. Hence, this study aimed to perform voxelwise diffusion tensor analysis for global detection of subtle white matter alterations in patients with ESRD.
MATERIALS AND METHODS
Twenty-eight patients with ESRD and 25 age-matched control subjects were enrolled in this study. Each subject underwent CASI assessment and DTI. After spatial normalization of DTI images, voxelwise statistical analyses were performed to compare DTI parameters between the 2 groups.
RESULTS
In patients with ESRD, AD, RD, and MD values were significantly increased, whereas the FA value was significantly decreased, mostly in the corpus callosum, bilateral sagittal stratum, and pons. Multiple regression analysis further revealed that both RD and MD were positively correlated with the duration of hemodialysis in the pons; however, no significant correlation was observed with FA. Negative correlations of RD and MD and a positive correlation of FA with the CASI score were observed in the corona radiata.
CONCLUSIONS
We concluded that voxelwise DTI analysis is helpful in the detection of white matter alterations caused by hemodialysis.
背景与目的
终末期肾病会导致尿素和有毒代谢物的过度积累。血液透析通常用于维持终末期肾病患者的健康，但它可能会在早期引起沉默的脑白质改变。因此，本研究旨在通过体素扩散张量分析对终末期肾病患者的细微脑白质改变进行全局检测。
材料与方法
本研究纳入了 28 名终末期肾病患者和 25 名年龄匹配的对照者。每位受试者均接受了认知状态检查和 DTI 检查。在对 DTI 图像进行空间标准化后，对两组之间的 DTI 参数进行了体素统计分析。
结果
与对照组相比，终末期肾病患者的 AD、RD 和 MD 值显著增加，而 FA 值显著降低，主要累及胼胝体、双侧矢状层和脑桥。多元回归分析进一步表明，脑桥内 RD 和 MD 与血液透析时间呈正相关，而与 FA 无明显相关性。在放射冠中，RD、MD 与 CASI 评分呈负相关，FA 与 CASI 评分呈正相关。
结论
我们得出结论，体素 DTI 分析有助于检测血液透析引起的脑白质改变。
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