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基于体素的形态测量学在脊髓小脑变性诊断中的应用

[The utility of voxel-based morphometry in the diagnosis of spinocerebellar degeneration].

作者信息

Tanaka Nobuyuki, Nanri Kazunori, Taguchi Takeshi, Tanaka Noriko, Fujita Tsuneo, Mitoma Hiroshi, Kawata Akihiro, Mizusawa Hidehiro

机构信息

Department of Neurology, Tokyo Medical University Hachioji Medical Center.

出版信息

Brain Nerve. 2014 Jun;66(6):699-704.

Abstract

We evaluated atrophic sites in the brainstem and cerebellum in the patients with spinocerebellar degeneration by using voxel-based morphometry (VBM). Gray matter atrophy was found extensively in both the cerebellar hemispheres and vermis of subjects presenting the cerebellar variant of multiple system atrophy (MSA-C; n=9). In addition, remarkable white matter atrophy was observed in the middle cerebellar peduncle, brainstem, and cerebellar hemispheres. In contrast, gray matter atrophy was not apparent in the cerebellar hemispheres or vermis of subjects in the SCA3 group (n=6), whereas intense white matter atrophy was visible in the middle cerebellar peduncle, brainstem, and cerebellar hemispheres. White matter atrophy was also observed in the brainstem and surrounding the dentate nucleus in both cases of dentatorubral-pallidoluysian atrophy (DRPLA) (n=2), whereas gray matter atrophy of the cerebellum was not remarkable. In both the SCA6 group (n=3) and the SCA31 group (n=2), gray matter atrophy was prominent in the cerebellar hemispheres and vermis; however, white matter atrophy was not found in the middle cerebellar peduncle and brainstem, whereas symmetric atrophy of white matter was found in the vicinity of the dentate nucleus. In each of these diseases, VBM findings were consistent with the pathological findings; therefore, VBM can be considered a useful tool for the diagnosis of spinocerebellar degeneration.

摘要

我们运用基于体素的形态测量法(VBM)对脊髓小脑变性患者脑干和小脑的萎缩部位进行了评估。在呈现多系统萎缩小脑型(MSA-C;n = 9)的受试者中,小脑半球和蚓部均广泛存在灰质萎缩。此外,在小脑中脚、脑干和小脑半球观察到明显的白质萎缩。相比之下,SCA3组(n = 6)受试者的小脑半球或蚓部未出现明显的灰质萎缩,而在小脑中脚、脑干和小脑半球可见强烈的白质萎缩。在齿状核红核苍白球路易体萎缩(DRPLA)的2例患者(n = 2)中,脑干和齿状核周围也观察到白质萎缩,而小脑的灰质萎缩并不显著。在SCA6组(n = 3)和SCA31组(n = 2)中,小脑半球和蚓部的灰质萎缩均较为突出;然而,小脑中脚和脑干未发现白质萎缩,而在齿状核附近发现白质呈对称性萎缩。在上述每种疾病中,VBM的结果均与病理结果一致;因此,VBM可被视为诊断脊髓小脑变性的一种有用工具。

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