磁敏感序列成像联合磁共振波谱技术对首发抑郁症海马区静脉变化及细胞代谢的研究

摘要

目的：联合磁敏感序列成像（SWI）及磁共振波谱（1H-MRS）技术研究首发抑郁症患者海马区静脉及海马区细胞代谢变化之间的关系。方法对2013年10月至2015年10月该院收治的20例首发抑郁症患者（首发抑郁组）及来自医院职工或其家属的20例健康志愿者（健康组）分别采用SWI及1H-MRS序列进行扫描，检测双侧海马区引流静脉的最大直径、长度、分支数目及各代谢指标[包括谷氨酰胺复合物（Glx）、乙酰天门冬氨酸盐（NAA）、胆碱（Cho）、肌酐（Cr）、肌醇（MI）]，并将引流静脉变化与细胞代谢水平进行相关性分析。结果首发抑郁组患者左侧脑室下静脉的最大直径较健康组变窄，差异有统计学意义（P<0.05），而长度及分支较健康组增高，但差异均无统计学意义（P>0.05）；右侧脑室下静脉的最大直径较健康组变窄，差异有统计学意义（P<0.05），长度及分支较健康组未见明显变化，差异均无统计学意义（P>0.05）。与健康组比较，首发抑郁组患者左侧海马区的Glx/Cr及NAA/Cr下降，而Cho/Cr升高，差异均有统计学意义（t=2.69、2.81、2.36，P<0.05），MI/Cr变化不明显，差异无统计学意义（t=1.19，P>0.05）；右侧海马区仅出现Glx/Cr下降，差异有统计学意义（t=2.43，P<0.05）。左侧脑室下静脉的最大直径与左侧海马区的Cho/Cr水平呈明显负相关（r=-0.631，P<0.05），与左侧海马区的Glx/Cr、NAA/Cr及MI/Cr水平呈明显正相关（r=0.568、0.594、0.095，P<0.05）。结论首发抑郁症患者海马区的引流静脉出现形态上的变化，这些变化影响了双侧海马区的神经细胞代谢，可能是首发抑郁症发病机制的一种潜在因素。%Objective To combine SWI with 1H-MRS for exploring the relationship of veins and nerve cells metabolism changes of the bilateral hippocampus regions in the patients with first episode depression. Methods The subsequence of SWI and 1H-MRS was adopted to scan 20 patients with first episode depression (first episode depression group) and 20 healthy volun-teers from the hospital staff or their family members(health group) in our hospital from October 2013 to October 2015 for detecting maximum diameter,length and branch numbers of the bilateral hippocampus draining veins and multiple metabolic indices (Glx, NAA,Cho,Cr and MI)of the bilateral hippocampus,finally,analyzing the correlation between them. Results Compared with the health group,the maximum diameter of left inferior ventricular vein in the first episode depression group became narrow with sta tistical difference(P<0.05),while the length and branch numbers were increased,but without statistically significant difference (P>0.05);the maximum diameter of right inferior ventricular vein became narrow compared with the health group ,the difference was statistically significant(P<0.05),while the length and branch numbers had unobvious change without statistical difference (P>0.05). Compared with the health group,the values of Glx/Cr and NAA/Cr of left hippocampus in the first episode depression group were reduced,while the value of Cho/Cr was increased,the differences were statistically significant(t=2.69,2.81,2.36,P<0.05), while the value of MI/Cr had no obvious change,the differences were statistically significant(t=1.19,P>0.05);only the value of Glx/Cr in right hippocampus was reduced with statistical difference (t=2.43,P<0.05). The maximum diameter of left inferior ventricu-lar vein was negatively correlated to the value of Cho/Cr and positively correlated to the value of Glx/Cr ,NAA/Cr and MI/Cr in left hippocampus(r=0.568,0.594,0.095,P<0.05). Conclusion The morphological change of draining veins in hippocampus appears in the patients with first episode depression,these changes affect the nerve cell metabolism of the bilateral hippocampus,which may be one of the potential factors of first episode depression pathogenesis.