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1、磁共振弥散张量成像在原发性青光眼视放射中的应用研究张放文雯2朱文卿2沙炎1(通讯作者)叶昕裴1王中江11复旦大学附属眼耳鼻喉科医院放射科;2复旦大学附属眼耳鼻喉科医院眼科摘要:目的:探讨磁共振弥散张量成像(diffusiontensorimaging,DTI)技术显示不同时期青光眼视放射神经变性的价值。方法:选择原发性青光眼早、晚期及正常对照组各15例行视觉通路DTI检查。分別测量左右两侧视放射的各向异性分数(fractionalanisotropy,FA)、平均弥散率(meandiffusivity,MD)、平行扩散率(axiald
2、iffusivities,λ//)和垂直扩散率(radialdiffusivities,λ⊥),使用SPSS16.0统计学软件分析病变组与对照组各参数之间的差异。结果:与正常对照组比较,早期青光眼患者视放射FA值、λ//值轻度降低,MD值轻度增高,差异无统计学意义(P>O.O5),λ⊥值显著升高(P=0.033);晚期青光眼患者视放射FA值、λ//值显著降低(P=0.000,P=0.028),MD值、λ⊥值显著升高(
3、P=0.043,P=0.000)。晚期青光眼较早期青光眼视放射FA值显著降低(P=0.000),λ⊥值显著升高(P=0.001),MD值7T高,λ//值降低,差异无统计学意义(P>;0.05)o结论:DTI技术可以多参数显示不同时期青光眼视放射的神经变性,并能一定程度上反映病变严重程度,FA值和λ⊥值较MD值和λ//值更能敏感地反映视放射的损害。关键词:原发性青光眼;扩散张量成像;视放射[Abstract]Purpose:Tostudythevalueof
4、MRdiffusiontensorimaging(DTI)inevaluatingtheneurodegenerativechangesofopticradiationsinprimaryglaucomapatients.Methods:Fifteenearlyglaucomapatients,15severeglaucomapatients,and15normalvolunteerswereenrolled.ConventionalMRIandDTIinvisualpathwaywereperformedonallsubjectsu
5、singSiemensVerio3Tscanner.Fractionalanisotropy(FA),meandiffusivity(MD),axialdiffusivities(λ//)andradialdiffusivities(λ⊥)weremeasuredinopticradiation,andthenthedifferencewascomparedbetweenpatientsgroupandcontrolgroupusingthestatisticalsoftwareofSPSS16.
6、0.Results:Comparedwithcontrolgroup,thevaluesofFAandSdambda;//inearlyglaucomawerelightlydecreased,andthatofMDwerelightlyincreased,whichwasnostatisticaldifference(P>0.05).Whilethevalueofλ⊥wassignificantlyhigherthanthatofincontrolgroup(P=0.033).Insevereglauc
7、oma,thevaluesofFAandλ//weredecreasedobviously(P=0.000,P=0.028)andthevaluesofMDandλ⊥wereincreasedsignificantly(P=0.043,P=0.000)thanthoseofincontrolgroup.Comparedwithearlyglaucoma,thevalueofFAinsevereglaucomawasobviouslydecreased(P=0.000)andthatof&lambd
8、a;⊥wassignificantlyincreased(p=0.001).WhilethevalueofMDwaslightlyincreased,thatofλ//waslightlydecr