扩散峰度成像在小儿结节性硬化症中的应用
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摘要
目的:探讨扩散峰度成像(DKI)对小儿结节性硬化症(TSC)的诊断价值。方法:对32例在本院经临床诊断为TSC的患儿行脑部DKI检查(b值为0、1000和2000s/mm~2,各有15个扩散方向),测量患儿67个灰质结节及45个白质病变的平均扩散峰度(MK)、轴向峰度(AK)及径向峰度(RK)值,并与对侧正常区域进行对照分析。结果:灰质结节和对侧正常灰质的MK、AK及RK值分别为0.57±0.14、0.47±0.09、0.62±0.12和0.72±0.11、0.49±0.07、0.76±0.13;灰质结节的MK、RK值显著低于正常灰质,差异均有统计学意义(P<0.01),而AK值的差异无统计学意义(P>0.05)。白质病变和对侧正常白质的MK、AK及RK值分别为0.63±0.16、0.54±0.09、0.66±0.14和0.78±0.11、0.60±0.11、0.86±0.12;白质病变的MK、RK值较对侧显著下降(P<0.001),而AK值与对侧比较差异无统计学意义(P>0.05)。结论:DKI测量参数可反映TSC患者脑组织内细胞结构的变化,可为研究TSC的微观病理改变提供依据。
Objective:To investigate the diagnostic value of diffusion kurtosis imaging(DKI)in pediatric patients with tuberous sclerosis complex(TSC).Methods:Thirty-two children with clinical diagnosis of tuberous sclerosis were enrolled in this study.DKI imaging of the brain(b values of 0,1000 and 2000 s/mm~2,each with 15 diffusion directions).The mean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)of grey matter tubers(n=67)and white matter lesions(n=45)were measured and compared with the contralateral normal area.Results:The MK,AK and RK values of gray matter tubes and contralateral normal gray matter were 0.57±0.14,0.47±0.09,0.62±0.12 and0.72±0.11,0.49±0.07,0.76±0.13 respectively;The MK,AK and RK values of the white matter lesions and contralateral normal white matter were 0.63±0.16,0.54±0.09,0.66±0.14 and 0.78±0.11,0.60±0.11,0.86±0.12,respectively.The MK and RK values of tubers were significantly lower than those of normal gray matter(all P<0.01),there was no significant difference in AK value.Compared with symmetric normal areas,the MK and RK values of white matter lesions decreased with significantly statistical difference(all P<0.001),while AK value was slightly decreased with no statistical difference(P>0.05).Conclusion:The change of DKI parameters can reveal the change of TSC cell structure and provide the basis for studying the microscopic pathological changes of TSC.
Objective:To investigate the diagnostic value of diffusion kurtosis imaging(DKI)in pediatric patients with tuberous sclerosis complex(TSC).Methods:Thirty-two children with clinical diagnosis of tuberous sclerosis were enrolled in this study.DKI imaging of the brain(b values of 0,1000 and 2000 s/mm~2,each with 15 diffusion directions).The mean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)of grey matter tubers(n=67)and white matter lesions(n=45)were measured and compared with the contralateral normal area.Results:The MK,AK and RK values of gray matter tubes and contralateral normal gray matter were 0.57±0.14,0.47±0.09,0.62±0.12 and0.72±0.11,0.49±0.07,0.76±0.13 respectively;The MK,AK and RK values of the white matter lesions and contralateral normal white matter were 0.63±0.16,0.54±0.09,0.66±0.14 and 0.78±0.11,0.60±0.11,0.86±0.12,respectively.The MK and RK values of tubers were significantly lower than those of normal gray matter(all P<0.01),there was no significant difference in AK value.Compared with symmetric normal areas,the MK and RK values of white matter lesions decreased with significantly statistical difference(all P<0.001),while AK value was slightly decreased with no statistical difference(P>0.05).Conclusion:The change of DKI parameters can reveal the change of TSC cell structure and provide the basis for studying the microscopic pathological changes of TSC.
引文
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[13]Dogan MS,Gumus K,Koc G,et al.Brain diffusion tensor imaging in children with tuberous sclerosis[J].Diagn Interv Imaging,2016,97(2):171-176.
[14]Baumer FM,Song JW,Mitchell PD,et al.Longitudinal changes in diffusion properties in white matter pathways of children with tuberous sclerosis complex[J].Neuroimage,2015,52(6):615-623.
[15]Arulrajah S,Ertan G,Jordan L,et al.Magnetic resonance imaging and diffusion-weighted imaging of normal-appearing white matter in children and young adults with tuberous sclerosis complex[J].Neuroradiology,2009,51(11):781-786.
[2]van Cauter S,Veraart J,Sijbers J,et al.Gliomas:diffusion kurtosis MR imaging in grading[J].Radiology,2012,263(3):452-501.
[3]Jensen JH,Helpern JA,Ramania A,et al.Diffusional kurtosis imaging:the quantification of non-Gaussian water diffusion by means of magnetic resonance imaging[J].Magn Reson Med,2005,53(6):1432-1440.
[4]Raab P,Hattingen E,Franz K,et al.Cerebral gliomas:diffusional kurtosis imaging analysis of microstructural differences[J].Radiology,2010,254(3):876-881.
[5]谭朝元,杨晶,严开心,等.扩散峰度成像对高级别胶质瘤及单发脑转移瘤的鉴别诊断价值[J].放射学实践,2017,32(3):218-222.
[6]张顺,姚义好,张水霞,等.脑梗死不同时期的MR扩散峰度成像表现[J].中华放射学杂志,2014,48(6):443-447.
[7]Serulle Y,Pawer RV,Eubig J,et al.Diffusional kurtosis imaging in hydrocephalus[J].Magn Reson Imaging,2015,33(5):531-536.
[8]叶德湫,陈向荣,黄永础,等.缺血性脑白质病额顶叶白质的扩散峰度表现[J].中国医学影像学杂志,2016,24(7):481-485.
[9]胡瑞,谭凡,陈学强,等.扩散峰度成像评价阿尔茨海默病患者脑白质微观结构的改变[J].中国医学影像技术,2016,32(1):35-39.
[10]Cheung MM,Hui ES,Chan KC,et al.Does diffusion kurtosis imaging lead to better neural tissue characterization:a rodent brain maturation study[J].Neuroimage,2009,45(2):386-392.
[11]Kelm ND,West KL,Carson RP,et al.Evaluation of diffusion kurtosis imaging in ex vivo hypomyelinated mouse brains[J].Neuroimage,2016,124(1):612-626.
[12]Ertan G,Arulrajah S,Tekes A,et al.Cerebellar abnormality in children and young adults with tuberous sclerosis complex:MR and diffusion weighted imaging findings[J].J Neuroradiol,2010,37(4):231-238.
[13]Dogan MS,Gumus K,Koc G,et al.Brain diffusion tensor imaging in children with tuberous sclerosis[J].Diagn Interv Imaging,2016,97(2):171-176.
[14]Baumer FM,Song JW,Mitchell PD,et al.Longitudinal changes in diffusion properties in white matter pathways of children with tuberous sclerosis complex[J].Neuroimage,2015,52(6):615-623.
[15]Arulrajah S,Ertan G,Jordan L,et al.Magnetic resonance imaging and diffusion-weighted imaging of normal-appearing white matter in children and young adults with tuberous sclerosis complex[J].Neuroradiology,2009,51(11):781-786.