摘要
目的联合磁共振质子波谱（1H—MRS）及T2信号强度两种手段对首发精神分裂症患者前额叶皮质进行研究，探讨其变化规律及潜在联系。方法收集34例首发未用药精神分裂症患者和健康对照35人。所有受试者分别行前额叶皮层的1H—MRS及快速白旋回波T2序列，分析精神分裂症患者前额叶皮质的代谢指标及T2信号强度的变化规律。并分析相关阳性指标与PANSS评分之间的相关性。结果精神分裂症患者双侧额叶NAA／Cr比值较对照组明显降低，差异有统计学意义（P〈0．05）；两组间双侧额叶Cho／Cr比值差异无统计学意义（P〉0．05）。精神分裂症患者双侧额叶上部磁共振T2信号强度较对照组明显增高，差异有统计学意义（t=2．07、2．18，P〈0．05）；精神分裂症患者左、右侧额叶中部及额叶下部磁共振T2信号强度与对照组相比差异均无统计学意义（P〉0．05）。精神分裂症患者左侧额叶上部磁共振T2信号与PANSS阴性症状分数、PANSS总分呈正相关（r=0．57、0．49，P〈0．05）。结论1H—MRS及1、2信号强度联合分析，可为精神分裂症临床早期诊断提供新的思路，借此思路或可解释首发精神分裂症患者前额叶皮质的神经元代谢异常及病理改变两者之间的潜在联系。
Objective Two methods of combined magnetic resonance proton spectroscopy （~H-MRS） and T2 signal intensity were used to study the prefrontal cortex of first episode schizophrenic patients, and to explore the changes and potential relationships of the patients with schizophrenia. Methods Thirty-four first- episode drug-free schizophrenics and thirty-five healthy subjects were enrolled and underwent 1H-MRS and FSE-T2 sequencing. All subjects underwent 1H-MRS and fast spin echo T2 sequences in the prefrontal cortex respectively. The metabolic indexes of prefrontal cortex and the changes of T2 signal intensity in patients with schizophrenia were explored. Additionally, the correlation between the related positive indexes and PANSS score were analyzed. Results Compared with the control group, the ratio of NAA/Cr of bilateral prefrontal cortex of the patients with schizophrenia decreased significantly, and the difference was statistically significant （P 〈 0.05）. While there was no significant difference in Cho/Cr of bilateral prefrontal cortex between the two groups （P 〉 0.05）. There were significant differences of the T2 signal intensity in the in the upper frontal （t=2.07, 2.18; P 〈 0.05）, while there were no significant differences in the middle frontal and inferior frontal （P 〉 0.05）. The MRI-T2 signal intensity in the left upper frontal was positively related to the negative syndrome scale and total score of PANSS （r=0.57, 0.49; P 〈 0.05）. Conclusions The combination of the 1H-MRS and T2 sequencing in prefrontal cortex of patients with first-episode schizophrenics can become a new idea in the early diagnosis of schizophrenia, and this idea may explain the causal relationship between the neuronal metabolic abnormalities and pathologic changes of the prefrontal cortex in schizophrenics.
作者
张渊
宋慧慧
顾卫国
孙洪言
袁念
Zhang Yuan;SongHuihui;Gu Weiguo;Sun Hongyan;Yuan Nian(Imaging Department, Suzhou Psychiatric Hospital, the AJfiliated Guangji Hospital of Soochow University, Suzhou 215137, China)
出处
《神经疾病与精神卫生》
2018年第4期240-243,共4页
Journal of Neuroscience and Mental Health
基金
苏州市科技局指令性项目（SYS201577）
苏州大学附属广济医院资助项目（gjyy201501）
关键词
精神分裂症
前额叶皮质
磁共振T2信号
质子波谱
Schizophrenia
Prefrontal cortex
MRI-T2 signals
Proton magnetic resonance spectroscopy
