1 Department of Radiology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.
Br J Radiol. 2014 Jun;87(1038):20130801. doi: 10.1259/bjr.20130801. Epub 2014 Apr 16.
We examined brain diffusion changes of patients with acromegaly. We searched whether there are differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values between remission and non-remission patients with acromegaly and investigated any effect of time of hormone exposure on diffusion metrics.
The values of FA and ADC were calculated in a total of 35 patients with acromegaly and 28 control subjects. Patients were subdivided into remission and non-remission groups. We looked at brain FA and ADC differences among the groups and looked for any relation between the diffusion changes and time of hormone exposure among the patients with acromegaly.
We found decreased FA and increased ADC values in some of the growth hormone responsive areas. There were no significant brain diffusion changes between remission and non-remission groups. The most affected areas were the hypothalamus, parietal white matter and pre-motor cortex in patients with acromegaly. In terms of hormone exposure time among the patients with acromegaly, there was no effect of disease duration on brain microstructural changes.
All patients with acromegaly showed increased brain diffusion with no relation to disease duration and treatment status. We suggested that in patients with acromegaly, brain damage had already occurred in the subclinical period before symptom onset.
This study contributes to the understanding of the mechanisms in acromegaly.
我们研究了肢端肥大症患者的脑弥散变化。我们探讨了肢端肥大症缓解组和未缓解组患者的表观扩散系数（ADC）和各向异性分数（FA）值是否存在差异，并研究了激素暴露时间对弥散指标的任何影响。
共对 35 例肢端肥大症患者和 28 例对照者进行了 FA 和 ADC 值的计算。将患者分为缓解组和未缓解组。我们观察了组间的脑 FA 和 ADC 差异，并观察了肢端肥大症患者中弥散变化与激素暴露时间之间的任何关系。
我们发现一些生长激素反应区域的 FA 值降低和 ADC 值升高。缓解组和未缓解组之间没有明显的脑弥散变化。受影响最严重的区域是肢端肥大症患者的下丘脑、顶叶白质和运动前皮质。就肢端肥大症患者的激素暴露时间而言，疾病持续时间对脑微观结构变化没有影响。
所有肢端肥大症患者的脑弥散均增加，与疾病持续时间和治疗状况无关。我们认为，在肢端肥大症患者中，在症状出现前的亚临床期已经发生了脑损伤。
本研究有助于了解肢端肥大症的发病机制。
