摘要
目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者脑白质损伤的特征及其与焦虑症状的相关性。方法:将33例未经治疗的中重度OSAHS患者及28例与患者组相匹配的无睡眠障碍志愿者(NSD)纳入本研究,所有被试行3.0T MR头部扫描,获得DTI数据及高分辨率薄层T1加权图像。采用纤维自动量化(AFQ)技术,提取每例被试全脑20条主要纤维束,将每条纤维束等分为100个节段,比较两组间各条纤维束DTI指标值的差异,并将OSAHS组中受损纤维节段的DTI张量指标值与患者的焦虑量表评分进行相关性分析。结果:相对于NSD组,OSAHS组中胼胝体大钳的第77~78段的FA值减低,右侧丘脑辐射的第23~24节段的MD值增高,右下额枕束第54~57节段及右上纵束第66~68节段的AD值增高(P<0.05)。并且胼胝体大钳第78受损节段的FA值与SAS量表评分呈正相关(r=0.447,P=0.009),右下额枕束第56受损节段的AD值与SAS量表评分呈负相关(r=-0.434,P=0.013)。结论:采用AFQ分析方法能够更加精细、准确地发现OSAHS患者脑白质纤维束的受损节段,胼胝体大钳及右下额枕束的局部损伤可能是OSAHS患者出现焦虑的神经病理学基础。
Objective:To analyze the characteristics of white matter damage in obstructive sleep apnea hypopnea syndrome(OSAHS)and to explore its correlation with anxiety.Methods:In this study,33 untreated patients with moderate to severe OSAHS and 28 non-sleep-disordered volunteers(NSD)matched with the patient group were subjected to 3.0T MRI head scan to obtain DTI data and high-resolution thin-slice T1WI images.The tensor indexes between the two groups were quantitatively analyzed using AFQ technology to extract 20 main fiber bundles of the whole brain.Each main fiber bundle was subdivided into 100 equal segments,and then the correlation between the OSAHS damaged fiber segments and the anxiety scale score was analyzed.Results:Compared with the NSD group,the OSAHS group had lower FA values in segments 77~78 of the callosum forceps major,greater MD values in segments 23~24 of the right thalamic radiation,and the AD values in segment 54~57 of the right inferior frontal occipital tract and segment 66~68 of the right superior longitudinal tract increased(all P<0.05).And the FA value of the 78 segment with damage of the callosum forceps major was positively correlated with the SAS scale score(r=0.447,P=0.009),and the AD value of the 56 segment with damage of the right inferior frontal occipital tract was negatively correlated with SAS(r=-0.434,P=0.013).Conclusion:The AFQ analysis method can be used to more finely and accurately find the damaged segments of the white matter fiber bundle in OSAHS patients.Injuries in the callosum forceps major and the local bundle of the right inferior frontal-occipital tract may be the neuropathological basis of anxiety in OSAHS patients.
作者
李丹阳
孙雨美
刘婉晴
胡冰
伍建林
张清
LI Dan-yang;SUN Yu-mei;LIU Wan-qing(Department of Radiology,Zhongshan Hospital,Dalian University,Liaoning 116000,China)
出处
《放射学实践》
北大核心
2020年第12期1519-1524,共6页
Radiologic Practice
基金
大连市卫计委大连市医学科学研究项目(181107)。
关键词
阻塞性睡眠呼吸暂停低通气综合征
纤维自动量化技术
扩散张量成像
脑白质纤维束
Obstructive sleep apnea hypopnea syndrome
Automated fiber quantification technique
Diffusion tensor imaging
White matter fiber bundle
