摘要
目的:研究并探讨急性轻型创伤性脑损伤(traumatic brain injury,TBI)患者的静息态脑功能磁共振成像(functional magnetic resonance imaging,fMRI)特征,为临床诊断提供指导依据。方法:选取2015年1月-2017年10月在本院就诊的急性轻型TBI患者30例为观察组,另选取同期在院进行体检的健康志愿者30例为对照组。两组均开展螺旋CT、静息态脑fMRI检查,以临床确诊结果为参照,比较螺旋CT、静息态脑fMRI对急性轻型TBI的诊断灵敏度、特异度、准确率;分析螺旋CT、静息态脑fMRI诊断结果与临床确诊结果间的诊断一致性;分析两组静息态脑fMRI图像。结果:静息态脑fMRI的诊断灵敏度、特异度、准确率分别为96.67%、93.33%、95.00%,均高于螺旋CT的80.00%、73.33%、76.67%,比较差异均有统计学意义(P<0.05);经一致性检验分析,静息态脑fMRI诊断TBI的结果与临床确诊结果间的一致性良好(Kappa=0.725),而螺旋CT诊断结果与临床确诊结果间的一致性中等(Kappa=0.519),不及静息态脑fMRI;对照组的默认网络分布于2个集群,1群MNI峰的X轴、Y轴、Z轴坐标分别为3/-42/36,2群MNI峰的X轴、Y轴、Z轴坐标分别为-48/69/39;观察组的默认网络分布于4个集群,1群MNI峰的X轴、Y轴、Z轴坐标分别为-9/60/-9,2群MNI峰的X轴、Y轴、Z轴坐标分别为33/-12/39,3群MNI峰的X轴、Y轴、Z轴坐标分别为-42/12/54,4群MNI峰的X轴、Y轴、Z轴坐标分别为48/27/45。结论:静息态脑fMRI图像中可见急性轻型TBI患者脑区默认网络功能发生异常改变,通过静息态fMRI检查可予以准确诊断,对其脑区默认网络功能改变予以灵敏反映。
Objective：To study and explore the characteristics of resting brain functional magnetic resonance imaging（fMRI） in patients with acute mild traumatic brain injury（TBI） and to provide guidance for clinical diagnosis.Method：A total of 30 patients with acute mild TBI from January 2015 to October 2017 in our hospital were selected as observation group and another 30 healthy volunteers who received physical examination in the same period were selected as control group.Spiral CT examination and resting brain fMRI examination were performed in two groups.Refer to the results of clinical diagnosis,the diagnostic sensitivity,specificity and accuracy of spiral CT and resting state brain fMRI in acute light TBI were compared.The diagnostic consistency between spiral CT and resting state brain fMRI and clinical diagnosis results were analyzed,the resting state brain fMRI images in two groups were analyzed.Result：The diagnostic sensitivity,specificity and accuracy of resting state fMRI were 96.67%,93.33% and 95.00% respectively,which were all higher than 80.00%,73.33% and 76.67% of spiral CT,the differences were statistically significant（P〈0.05）.The conformance test showed that the results of the resting state brain fMRI diagnosis of TBI were in good agreement with the clinical diagnosis（Kappa=0.725）,while the diagnostic results of spiral CT and the clinical diagnosis were moderate（Kappa=0.519）,not as good as the resting state fMRI.The default network of control group was distributed in 2 clusters,X,Y and Z axis coordinate of the 1 groups of MNI peaks were 3/-42/36,and X,Y and Z axis coordinate of the 2 groups MNI peaks were-48/69/39.The default network of observation group was distributed in 4 clusters,X,Y and Z axis coordinate of the 1 groups of MNI peaks were-9/60/-9,X,Y and Z axis coordinate of the 2 groups of MNI peaks were 33/-12/39,X,Y and Z axis coordinate of the 3 groups of MNI peaks were-42/12/54,X,Y and Z axis coordinate of the 4 groups of MNI peaks were 48/27/45.Conclusion：Abnormal ch
作者
黄钢材
侯刚强
谢井文
杨春勤
HUANG Gangcai;HOU Gangqiang;XIE Jingwen(Nanshan People’s Hospital,Shenzhen 518052,China)
出处
《中国医学创新》
CAS
2018年第15期1-4,共4页
Medical Innovation of China
基金
广东省自然科学基金项目(A2017620)
关键词
急性轻型创伤性脑损伤
诊断
静息态脑功能磁共振成像
Acute mild traumatic brain injury
Diagnosis
Resting brain functional magnetic resonance imaging
