发作性偏头痛中导水管周围灰质的容积扩大：一项MRI结构成像初步研究
Volume expansion of periaqueductal gray in episodic migraine: a pilot MRI structural imaging study.
作者信息
Chen Zhiye, Chen Xiaoyan, Liu Mengqi, Liu Shuangfeng, Ma Lin, Yu Shengyuan
机构信息
Department of Radiology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China.
Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China.
出版信息
J Headache Pain. 2017 Aug 15;18(1):83. doi: 10.1186/s10194-017-0797-z.
BACKGROUND
The periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were also observed in episodic migraine (EM) recently. However, the PAG volume change was not totally detected in EM up to now. Herein, the aim of this study was to investigate altered PAG volume in EM patients based on high resolution brain structural image.
METHODS
The brain structural images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) on 3.0 T MR system. PAG template was created based on the ICBM152 gray matter template using MRIcron, and the individual PAG was created by applying the deformation field to the PAG template after structural image segment. One-way analysis of covariance, partial correlation analysis and Receiver operating characteristics (ROC) curve were applied.
RESULTS
EM had a larger PAG volume (0.35 ± 0.02 ml) than that (0.32 ± 0.02 ml) of NC (P = 0.017). The PAG volume of CM (0.33 ± 0.02 ml) was negatively related to the VAS score (P = 0.03). ROC analysis demonstrated that PAG volume has higher diagnostic efficacy (AUC, 0.731; Sensitivity, 0.556; Specificity, 0.889) for NC vs. EM compared with that NC vs. CM (AUC, 0.634; Sensitivity, 0.438; Specificity, 0.833) and EM vs. CM (AUC, 0.618; Sensitivity, 0.813; Specificity, 0.556).
CONCLUSION
PAG volume expansion may be the direct impairment evidence on the brain in EM, and could be considered as a diagnostic and evaluated imaging biomarker in migraine.
背景
导水管周围灰质（PAG）功能障碍在偏头痛中已得到认可，最近在发作性偏头痛（EM）中也观察到非特异性PAG病变。然而，迄今为止，在EM中尚未完全检测到PAG体积变化。在此，本研究的目的是基于高分辨率脑结构图像研究EM患者PAG体积的改变。
方法
在3.0 T MR系统上从18名正常对照（NC）、18名EM患者和16名慢性偏头痛（CM）患者获取脑结构图像。使用MRIcron基于ICBM152灰质模板创建PAG模板，并在结构图像分割后将变形场应用于PAG模板来创建个体PAG。应用单因素协方差分析、偏相关分析和受试者操作特征（ROC）曲线。
结果
EM的PAG体积（0.35±0.02 ml）大于NC的PAG体积（0.32±0.02 ml）（P = 0.017）。CM的PAG体积（0.33±0.02 ml）与视觉模拟评分（VAS）呈负相关（P = 0.03）。ROC分析表明，与NC vs. CM（AUC，0.634；敏感性，0.438；特异性，0.833）和EM vs. CM（AUC，0.618；敏感性，0.813；特异性，0.556）相比，PAG体积对NC与EM的诊断效能更高（AUC，0.731；敏感性，0.556；特异性，0.889）。
结论
PAG体积扩大可能是EM患者脑内的直接损伤证据，可被视为偏头痛诊断和评估的影像学生物标志物。
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