静息态功能磁共振成像比率低频振幅变化在急性脑干梗死脑神经功能损伤中的价值分析
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摘要
目的分析静息态功能磁共振成像(fMRI)比率低频振幅(fALFF)变化在急性脑干梗死脑神经功能损伤及预后判断中的价值。方法选取成都医学院第一附属医院2016年7月至2017年5月收治的30例急性脑干梗死病人为观察组,同期选取在成都医学院第一附属医院体检结果无异常的30例志愿者为对照组。采集两组fMRI资料,分析两组fALFF值对大脑各个区域的活动情况,然后进行组间比较。结果与对照组比较,观察组急性脑干梗死后,在双侧楔前叶、双侧顶下小叶、双侧扣带回、小脑后叶以及右侧海马上的fALFF值均表现为减弱信号(t=-5.239、-5.894、-4.761、-10.682、-4.528、-6.948、-5.318、-4.963,均P<0.001),在双侧中央前回、左侧丘脑、额上回以及左尾状核上的fALFF值均表现为增强信号(t=5.602、4.982、11.327、6.283、5.309、4.668,均P<0.001)。结论病人在急性脑干梗死后,fALFF值会出现异常,fALFF值的变化对急性脑干梗死发病后的脑功能受损情况及预后的判断有一定的参考意义。
Objective To analyze the value of fractional amplitude of low-frequency fluctuation(fALFF) of resting-state functional magnetic resonance imaging(fMRI) in neurological impairment of patients with acute brain stem infarction.Methods Thirty patients with acute brain stem infarction admitted to The First Affiliated Hospital of Chengdu Medical College from July 2016 to May 2017 were enrolled as the research group,and 30 volunteers who had no abnormal results of health examination in The First Affiliated Hospital of Chengdu Medical College during the same period were selected as controls(normal group).FMRI data of the two groups of subjects were collected.The fALFF values in different regions of the brain were analyzed and compared between the two groups.Results Compared with the control group,the fALFF values in the bilateral anterior lobe,the inferior parietal lobule,the bilateral cingulate gyrus,the posterior cerebellar lobe and the right hippocampus of the research group showed weakened signals after acute brain stem infarction(t=-5.239,-5.894,-4.761,-10.682,-4.528,-6.948,-5.318,and-4.963,respectively,all P<0.001).Compared with the control group,the fALFF values in the bilateral precentral gyrus,left thalamus,superior frontal gyrus and left caudate nucleus of the research group showed enhanced signals after acute brain stem infarction(t=5.602,4.982,11.327,6.283,5.309,and 4.668,respectively,all P<0.001).Conclusion In patients with acute brain stem infarction,the fractional amplitude of low-frequency fluctuation of functional magnetic resonance imaging will appear abnormal,which has a certain reference value for judging the impairment of brain function and prognosis of the patients.
Objective To analyze the value of fractional amplitude of low-frequency fluctuation(fALFF) of resting-state functional magnetic resonance imaging(fMRI) in neurological impairment of patients with acute brain stem infarction.Methods Thirty patients with acute brain stem infarction admitted to The First Affiliated Hospital of Chengdu Medical College from July 2016 to May 2017 were enrolled as the research group,and 30 volunteers who had no abnormal results of health examination in The First Affiliated Hospital of Chengdu Medical College during the same period were selected as controls(normal group).FMRI data of the two groups of subjects were collected.The fALFF values in different regions of the brain were analyzed and compared between the two groups.Results Compared with the control group,the fALFF values in the bilateral anterior lobe,the inferior parietal lobule,the bilateral cingulate gyrus,the posterior cerebellar lobe and the right hippocampus of the research group showed weakened signals after acute brain stem infarction(t=-5.239,-5.894,-4.761,-10.682,-4.528,-6.948,-5.318,and-4.963,respectively,all P<0.001).Compared with the control group,the fALFF values in the bilateral precentral gyrus,left thalamus,superior frontal gyrus and left caudate nucleus of the research group showed enhanced signals after acute brain stem infarction(t=5.602,4.982,11.327,6.283,5.309,and 4.668,respectively,all P<0.001).Conclusion In patients with acute brain stem infarction,the fractional amplitude of low-frequency fluctuation of functional magnetic resonance imaging will appear abnormal,which has a certain reference value for judging the impairment of brain function and prognosis of the patients.
引文
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[14] 姚群立,张洪英,方芳,等.超急性期脑缺血静息态脑功能磁共振网络信号变化的实验研究[J].中华医学杂志,2011,91(13):885-889.
[15] 戚婉,施敏敏,刘碧英,等.静息态功能磁共振在急性脑梗死患者运动功能康复中的应用[J].康复学报,2016,26(5):21-24.
[2] 孙晓燕,谢炳玓.不同梗死部位急性脑梗死患者血浆 D 二聚体水平变化及其与神经功能缺损程度的关系[J].山东医药,2016,56(15):57-59.
[3] SUZUKI H,TSUNEMATSU T,TAKAHASHI H,et al.A case of heparin-induced thrombocytopenia with subacute stent thrombosis,multiple cerebral infarction,and acute limb ischemia[J].J Cardiol Cases,2017,15(5):145-149.
[4] 曾令延,李涛,杨文兵,等.脑缺血灶和脑梗死的CT、MRI图像比较分析[J].中国医药导刊,2012,14(9):1513.
[5] ZHANG MJ,ZHANG X,XU YX.Analysis on value of CT and MRI clinical application in diagnosis of middle-aged patients with multiple cerebral infarction[J].Int J Clin Exp Med,2015,8(10):17123-17127.
[6] 王辉,陈楠,李坤成,等.桥脑梗死的磁共振静息态功能连接多模态应用研究[J].医学影像学杂志,2016,26(1):1-5.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[8] WU RH,FENG C,XU Y,et al.Late-onset depression in the absence of stroke:associated with silent brain infarctions,microbleeds and lesion locations[J].Int J Med Sci,2014,11(6):587-592.
[9] 郑勇强,刘冬柏,孟宪平,等.脑干梗死后低频振幅静息态 fM RI 的相关研究[J].东南大学学报(医学版),2015,34(2):186-190.
[10] PIKUSA M,JOCZYK R.Functional abnormalities in Broca's area in adolescents with ADHD:a resting-state fMRI study[J].Poznan Studies in Contemporary Linguistics,2015,51(1):163-177.
[11] 王辉,卢洁,李坤成,等.应用静息态功能磁共振成像分数低频振幅技术观察脑梗死患者大脑基线功能的变化[J].中国医学影像技术,2010,26(11):2041-2044.
[12] 叶梅萍,倪玲,张鑫,等.伴发腔隙性脑梗死的轻度认知功能障碍患者静息态功能磁共振成像研究[J].功能与分子医学影像学杂志(电子版),2016,5(3):6-13.DOI:10.3969/j.issn.2095-2252.2016.03.002.
[13] WALBERER M,TSCHERNATSCH M,FISCHER S,et al.RNase therapy assessed by magnetic resonance imaging reduces cerebral edema and infarction size in acute stroke[J].Curr Neurovasc Res,2009,6(1):12-19.
[14] 姚群立,张洪英,方芳,等.超急性期脑缺血静息态脑功能磁共振网络信号变化的实验研究[J].中华医学杂志,2011,91(13):885-889.
[15] 戚婉,施敏敏,刘碧英,等.静息态功能磁共振在急性脑梗死患者运动功能康复中的应用[J].康复学报,2016,26(5):21-24.
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