Wang Guifang, Zhang Chuanchen, Chen Wei, Yang Xiafeng, Sun Yihua, Li Shuhua
Department of neurology, Brain Hospital, Liaocheng People's hospital, 252000, China.
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Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2014 Oct;32(10):769-71.
To explore the diagnostic value of magnetic resonance (MR) diffusion tensor imaging (DTI) in detecting brain white matter (WM) damage of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and evaluating their cognitive dysfunction.
Thirteen patients with DEACMP and thirteen age- and sex-matched volunteers underwent DTI using 1.5T MR scanner. FA and ADC values of 16 WM regions of interests (ROIs) were measured on DTI by two experienced radiologists independently with double blind methods, cognitive functions were evaluated by another experienced neurologist blinded to patient's medical history using the Montreal cognitive assessment (MoCA). ADC and FA values in DEACMP patients, and their correlations with cognitive dysfunction were analyzed.
ADC values of DEACMP patients increased significantly in all ROIs (P < 0.05) in comparison with the corresponding ROIs of healthy controls, whereas FA values were significantly decreased in all ROIs (P < 0.05) in comparison with that in controls except the bilateral optic radiations, anterior and posterior internal capsules. MoCA scores were positively correlated with FA values of bilateral lower frontal (r(L) = 0.736, P = 0.011; r(R) = 0.762, P = 0.003) lobe, temporal lobe (r(L) = 0.605, P = 0.016; r(R) = 0.559, P = 0.021) and total average WM (r(A) = 0.688, P = 0.001), however it inversely correlated with ADC values of bilateral lower frontal WM (r(L) = -0.674, P = 0.007; r(R) = -0.681, P = 0.019).
DTI can quantitatively reveal WM microstructure damage of DEACMP patients, indicate the severity of cognitive dysfunctions, and provide important information for pathogenesis and pathological study for DEACMP.
探讨磁共振(MR)扩散张量成像(DTI)在检测急性一氧化碳中毒后迟发性脑病(DEACMP)患者脑白质(WM)损伤及评估其认知功能障碍方面的诊断价值。
13例DEACMP患者及13例年龄、性别匹配的志愿者接受1.5T MR扫描仪的DTI检查。由两名经验丰富的放射科医生采用双盲法独立测量DTI上16个WM感兴趣区(ROI)的FA和ADC值,另一名对患者病史不知情的经验丰富的神经科医生使用蒙特利尔认知评估(MoCA)对认知功能进行评估。分析DEACMP患者的ADC和FA值及其与认知功能障碍的相关性。
与健康对照组相应ROI相比,DEACMP患者所有ROI的ADC值均显著升高(P<0.05),而除双侧视辐射、内囊前肢和后肢外,所有ROI的FA值与对照组相比均显著降低(P<0.05)。MoCA评分与双侧额下回(r(L)=0.736,P=0.011;r(R)=0.762,P=0.003)、颞叶(r(L)=0.605,P=0.016;r(R)=0.559,P=0.021)及全脑平均WM(r(A)=0.688,P=0.001)的FA值呈正相关,而与双侧额下回WM的ADC值呈负相关(r(L)=-0.674,P=0.007;r(R)=-0.681,P=0.019)。
DTI能定量揭示DEACMP患者WM微观结构损伤,提示认知功能障碍的严重程度,为DEACMP的发病机制及病理研究提供重要信息。