Szczepek Ewa, Czerwosz Leszek, Szary Cezary, Czernicki Zbigniew
Pol Merkur Lekarski. 2014 Oct;37(220):221-6.
Clinical symptomatology of idiopathic normal pressure hydrocephalus, due to its overlap with dementias and neurodegenerative brain disorders, makes diagnosis challenging. As the neurological deficits are reversible there is a need for prompt and reliable noninvasive testing. The aim was to try to use and introduction into clinical practice of new non-invasive method--diffusion tensor imaging (DTI-Diffusion Tensor Imaging) discriminating patients classified as normal pressure hydrocephalus and patients diagnosed with brain atrophy.
Using magnetic resonance-diffusion tensor imaging, we examined white matter changes within the brains of patients diagnosed with idiopathic normal pressure hydrocephalus, cerebral atrophy and controls. Diffusion tensor brain images were obtained with 3Tesla and 1.5 Tesla MR-scanners. Fractional anisotropy brain maps were generated using a computer-automated method, and tract-based spatial statistics were then applied to compare the fractional anisotropy values in the clinical groups. The fractional anisotropy data were further investigated using region-of- interest analysis set within: fibre commissural the lateral ventricles (Fclv), forceps minor of corpus callosum (Fmin), cingulum (Cg), optic radiation (Orad), superior cerebellarpeduncle (Scp), substantia nigra (nucleus ruber) (Sn).
Compared with the cerebral atrophy or control group, the FA values in the hydrocephalus group were significantly different in the posterior cingulate (Cg) and the forceps minor of the corpus callosum (Fmin).
The pattern of white matter tracts changes in select brain regions distinguishes it from cerebral atrophy and control brains. Our pilot study adds to the body of knowledge advancing the understanding of the white matter pathology of idiopathic normal- pressure hydrocephalus.
特发性正常压力脑积水的临床症状学，因其与痴呆症和神经退行性脑疾病重叠，使得诊断具有挑战性。由于神经功能缺损是可逆的，因此需要快速且可靠的非侵入性检测。目的是尝试将一种新的非侵入性方法——扩散张量成像（DTI - 扩散张量成像）应用于临床实践，并用于区分被归类为正常压力脑积水的患者和被诊断为脑萎缩的患者。
我们使用磁共振扩散张量成像检查了被诊断为特发性正常压力脑积水、脑萎缩的患者以及对照组患者大脑中的白质变化。使用3特斯拉和1.5特斯拉的磁共振扫描仪获取扩散张量脑图像。使用计算机自动化方法生成分数各向异性脑图谱，然后应用基于体素的空间统计学方法比较临床组中的分数各向异性值。使用设定在以下区域的感兴趣区域分析进一步研究分数各向异性数据：纤维连合侧脑室（Fclv）、胼胝体小钳（Fmin）、扣带（Cg）、视辐射（Orad）、上小脑脚（Scp）、黑质（红核）（Sn）。
与脑萎缩组或对照组相比，脑积水组在后扣带回（Cg）和胼胝体小钳（Fmin）中的FA值有显著差异。
特定脑区白质束变化模式将其与脑萎缩和对照脑区分开来。我们的初步研究增加了对特发性正常压力脑积水白质病理学理解的知识体系。
