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视神经脊髓炎视觉通路中扩散张量成像与视觉诱发电位的关系研究

[STUDY ON RELATIONSHIP BETWEEN DIFFUSION TENSOR IMAGING AND VISUAL EVOKED POTENTIAL IN VISUAL PATHWAY OF NEUROMYELITIS OPTICA].

作者信息

Zhang Yan, Chen Xiuying, He Dian, Wu Qizhu, Gong Qiyong, Zhou Hongyu

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Jul;29(7):853-6.

Abstract

OBJECTIVE

To study the relationship between brain white matter fiber occult lesions and P100 wave latency of visual evoked potential (VEP) in neuromyelitis optica (NMO) patients by diffusion tensor imaging (DTI).

METHODS

Twenty patients with NMO who were treated between July 2008 and April 2009 were selected as the trial group. According to the VEP test, the latency of P100 wave was prolonged, the NMO patients were divided into VEP abnormal group (trial group 1) and VEP normal group (trial group 2). Twenty healthy adult volunteers served as the control group. The DTI examination in brain was done to measure the fractional anisotropy (FA) value of optic nerve (FAn), optic tract (FAt), and optic radiation (FAr); and the mean diffusivity (MD) value of optic nerve (MDn), optic tract (MDt), and optic radiation (MDr). The FA, MD, and P100 wave latency were compared between groups, and the correlation between MD, FA, and P100 wave latency of NMO were analyzed.

RESULTS

In the 20 NMO patients, 13 patients with VEP had prolonged bilateral P100 wave latency prolongation or no wave (trial group 1), and 7 patients had normal bilateral P100 wave latency (trial group 2). Compared with the trial group 2 and the control group, the FA values were significantly decreased, and the MD values were significantly increased in the trial group 1 (P < 0.05). There was no significant difference in the FA and MD values between the trial group 2 and the control group (P > 0.05). All FA (FAn, FAt, and FAr) values of each part of NMO patients were negatively correlated with the latency of P100 wave (P < 0.05), all MD (MDn, MDt, and MDr) values were positively correlated with the latency of P100 wave (P < 0.05).

CONCLUSION

DTI could show small pathylogical changes in the white matter fibers of visual pathway, and there is a correlation between DTI and VEP in NMO, suggesting that a more comprehensive assessment to the condition and prognosis can be made through the VEP in the clinical indicators.

摘要

目的

采用弥散张量成像(DTI)研究视神经脊髓炎(NMO)患者脑白质纤维隐匿性病变与视觉诱发电位(VEP)P100波潜伏期之间的关系。

方法

选取2008年7月至2009年4月期间接受治疗的20例NMO患者作为试验组。根据VEP检测结果,将P100波潜伏期延长的NMO患者分为VEP异常组(试验组1)和VEP正常组(试验组2)。选取20名健康成年志愿者作为对照组。对脑部进行DTI检查,测量视神经(FAn)、视束(FAt)和视辐射(FAr)的各向异性分数(FA)值;以及视神经(MDn)、视束(MDt)和视辐射(MDr)的平均扩散率(MD)值。比较各组之间的FA、MD和P100波潜伏期,并分析NMO患者MD、FA与P100波潜伏期之间的相关性。

结果

20例NMO患者中,13例VEP患者双侧P100波潜伏期延长或无波(试验组1),7例患者双侧P100波潜伏期正常(试验组2)。与试验组2和对照组相比,试验组1的FA值显著降低,MD值显著升高(P<0.05)。试验组2和对照组之间的FA和MD值无显著差异(P>0.05)。NMO患者各部位的所有FA(FAn、FAt和FAr)值与P100波潜伏期呈负相关(P<0.05),所有MD(MDn、MDt和MDr)值与P100波潜伏期呈正相关(P<0.05)。

结论

DTI能够显示视觉通路白质纤维的微小病理变化,NMO患者中DTI与VEP之间存在相关性,提示在临床指标中通过VEP可对病情及预后进行更全面的评估。

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