Xu Z F, Sun J S, Zhang X H, Feng Y Y, Pan A Z, Gao M Y, Zhao H
Department of Radiology, The First People's Hospital of Foshan, Guagndong, 528000, China.
Department of Radiology, The LeCong Hospital of ShunDe, Guagndong, 528000, China.
Clin Radiol. 2018 Jun;73(6):591.e9-591.e15. doi: 10.1016/j.crad.2018.01.010. Epub 2018 Feb 16.
To evaluate microstructural visual pathway damage in patients with primary glaucoma (PG) by using 3 T diffusion kurtosis imaging (DKI).
The study was approved by the ethics committee, and all participants provided written informed consent. Ten patients with PG were examined. Twenty healthy individuals served as control subjects. DKI was performed with a GE Silent 3 T magnetic resonance imaging (MRI) unit. Mean diffusivity (MD), fractional anisotropy (FA), and mean kurtosis (MK) maps were automatically created. Mean MK, MD, and FA values were calculated for each part of the visual pathway.
No abnormalities in the shape and signal intensity were observed along the entire visual pathway in patients and the control group on the conventional MRI. Higher MD, and lower MK and FA were observed in the optic nerves (ON), lateral geniculate nucleus (LGN), optic radiations (OR), and visual cortex (VCx) of PG patients, as compared with control subjects. A significantly higher MD was observed in the ON (p<0.01), and significantly lower FA was observed in OR (p<0.05). Additionally, significantly lower MK was observed in the ON, LGN, and VCx, except for OR (p<0.01). Changes of DKI parameters in the ON were the most distinct.
Glaucoma is a complex neurological disease that affects the entire visual pathway. MK derived from DKI would be a better biomarkers than FA and MD in detecting microstructural damage.
采用3T扩散峰度成像（DKI）评估原发性青光眼（PG）患者的微观结构视觉通路损伤。
本研究经伦理委员会批准，所有参与者均提供了书面知情同意书。对10例PG患者进行了检查。20名健康个体作为对照。使用GE Silent 3T磁共振成像（MRI）设备进行DKI检查。自动生成平均扩散率（MD）、各向异性分数（FA）和平均峰度（MK）图。计算视觉通路各部分的平均MK、MD和FA值。
在常规MRI上，患者和对照组的整个视觉通路均未观察到形状和信号强度异常。与对照组相比，PG患者的视神经（ON）、外侧膝状体（LGN）、视辐射（OR）和视觉皮层（VCx）的MD较高，MK和FA较低。在ON中观察到显著较高的MD（p<0.01），在OR中观察到显著较低的FA（p<0.05）。此外，除OR外，在ON、LGN和VCx中观察到显著较低的MK（p<0.01）。ON中DKI参数的变化最为明显。
青光眼是一种影响整个视觉通路的复杂神经疾病。与FA和MD相比，DKI衍生的MK在检测微观结构损伤方面将是更好的生物标志物。
