摘要
目的观察磁共振波谱分析(MRS)所示双侧海马代谢物改变对于诊断首发抑郁症(DD)的意义。方法对44例首发DD患者(DD组)及20名正常人(对照组)测量双侧海马肌酸(Cr)、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌醇(MI)峰下面积,计算NAA/Cr、Cho/Cr及MI/Cr,分析组间各指标差异;采用Logistic回归建立预测模型,以ROC曲线计算相关代谢物改变,作为首发DD临床诊断指标,并基于约登指数得出诊断阈值。结果DD组右侧海马Cho、NAA/Cr、Cho/Cr值均低于对照组(P均<0.05),右侧海马NAA、Cho、NAA/Cr、Cho/Cr和预测模型诊断DD的敏感度分别为54.54%、50.00%、45.45%、63.63%和77.27%,特异度分别为90.00%、100%、100%、80.00%和80.00%。结论MRS可辅助诊断首发DD;海马区Cho及Cho/Cr下降可能是早期DD标志,Cho、NAA/Cr及Cho/Cr可作为诊断首发DD的指标。
Objective To observe the value of hippocampal metabolite changes detected with magnetic resonance spectroscopy(MRS)for diagnosis of first-episode depression disorder(DD).Methods Creatine(Cr),N-acetylaspartate(NAA),choline(Cho)and inositol(MI)peak area in bilateral hippocampus were measured in 44 patients with first-episode DD(DD group)and 20 normal subjects(control group).The ratio of NAA/Cr,Cho/Cr and MI/Cr were calculated,and the indexes were compared between 2 groups.Then prediction model was established using Logistic regression,and the changes of related metabolites were calculated with ROC curve and taken as the clinical diagnostic indexes of first-episode DD,while the diagnosis threshold was given based on Youden index.Results Cho,NAA/Cr,Cho/Cr in right hippocampus of DD group were all significantly higher than those in control group(all P<0.05),the sensitivity of Cho,NAA/Cr,Cho/Cr in right hippocampus and prediction model for diagnosis of DD was 54.54%,50.00%,45.45%,63.63%and 77.27%,the specificity was 90.00%,100%,100%,80.00%and 80.00%,respectively.Conclusion MRS might assist diagnosis of first-episode DD.The decrease of Cho and Cho/Cr in hippocampus might be signs of DD,while Cho,NAA/Cr and Cho/Cr could be used as diagnostic markers.
作者
王晓
胡晓
刘海燕
黄清玲
柴学
李宗鸿
胡君
肖朝勇
WANG Xiao;HU Xiao;LIU Haiyan;HUANG Qingling;CHAI Xue;LI Zonghong;HU Jun;XIAO Chaoyong(Department of Radiology,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Psychiatry,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)
出处
《中国医学影像技术》
CSCD
北大核心
2021年第2期189-193,共5页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金青年科学基金(81701671)
南京市医学科技发展项目(YKK11032)。
关键词
抑郁症
磁共振波谱学
海马
depressive disorder
magnetic resonance spectroscopy
hippocampus
