磁共振成像扩散峰度成像技术对抑郁症患者脑微观结构变化的评估价值

摘要

目的：运用磁共振成像（ MRI）扩散峰度成像技术（ DKI）观察抑郁症患者脑微观结构的变化，从影像学角度为抑郁症的发病机制提供有价值的信息。方法搜集2012年2月—2013年10月新疆医科大学第一附属医院心理医学科确诊的抑郁症患者28例为病例组，筛选年龄、受教育程度与之匹配的28例健康志愿者为对照组，先行常规MRI检查，再采用DKI测量双侧额叶、颞叶、枕叶的脑白质和胼胝体膝部及压部的部分各向异性（ FA）值、平均峰度（ MK）值及平均扩散（ MD）值。结果病例组与对照组双侧额上回、额中回、额下回、枕叶、胼胝体膝部及压部FA值比较，差异均无统计学意义（P>0.05）；病例组双侧颞叶FA值较对照组降低（P<0.05）。病例组与对照组双侧额中回、额下回、枕叶、胼胝体膝部及压部MK值比较，差异均无统计学意义（ P>0.05）；病例组双侧额上回、双侧颞叶MK值较对照组降低（P<0.05）。病例组与对照组双侧额上回、额中回、额下回、颞叶、枕叶、胼胝体膝部及压部MD值比较，差异均无统计学意义（ P>0.05）。结论 DKI可以反映抑郁症患者脑的细微结构改变，双侧额上回、颞叶脑白质纤维束可能存在萎缩，为抑郁症的诊断提供了一定信息。%Objective To observe cerebric microstructure changes of depression patients using magnetic resonance im-aging( MRI)diffusion kurtosis imaging( DKI),and to provide valuable informations for pathogenesis of depression from the per-spective of radiography. Methods 28 confirmed depression cases who were diagnosed in Department of Psychology of the First Af-filiated Hospital of Xinjiang Medical University from February 2012 to October 2013,were taken as the case group,and 28 age-and education level-matched healthy volunteers were taken as the control group. All cases received routine MRI first,then re-ceived DKI. The mean kurtosis( MK),the fractional anisotropy( FA)and the mean diffusion( MD)values of cerebral white matter in the bilateral frontal lobe the bilateral temporal lobe and the occipital lobe,the genu of corpus callosum and the splenium corporis callosi were measured. Results There was no significant difference in FA values of bilateral superior frontal gyrus,mid-dle frontal gyrus,inferior frontal gyrus,the occipital lobe,the genu of corpus callosum and the splenium corporis callosi between the case group and the control group(P>0. 05). FA value of the bilateral temporal lobe of the case group was significantly lower than that of the control group(P<0. 05). There was no significant difference in MK values of bilateral middle frontal gyrus,in-ferior frontal gyrus,the occipital lobe,the genu of corpus callosum and the splenium corporis callosi between the case group and the control group( P>0. 05 ) . The MK value of the bilateral superior frontal gyrus and the temporosphenoid lobe of the case group was significantly lower than that of the control group(P<0. 05). There was no significant difference in MD values of bilat-eral superior frontal gyrus,middle frontal gyrus,inferior frontal gyrus,the temporal lobe,the occipital lobe,the genu of corpus callosum and the splenium corporis callosi between the case group and the control group( P>0. 05 ) . Conclusion DKI tech-nique can show cerebric microstructure change of depressed patients. The atrophy may exist in white matter fiber tracts of bilateral superior frontal gyrus and temporal lobe,which may contribute to the diagnosis of depression.