摘要
目的通过比较观察脊髓型颈椎病(CSM)患者的脊髓结构损害与大脑功能重塑情况,分析CSM患者影像表现与临床症状不一致("影症不一")的相关机制。方法根据日本骨科协会(JOA)17分法,对22例轻中度CSM患者、18例重度CSM患者及25名年龄、性别等均匹配的健康对照组(HC)行静息态功能磁共振成像(rs-fMRI),计算所有受试者的度中心度(DC)值,观察不同严重程度CSM患者DC值相比HC组改变的脑区,并比较各被试组间DC值的差异;同时测量C2、3椎间盘水平脊髓背索、皮质脊髓束各向异性分数(FA)值。用Pearson线性分析异常脑区DC值、临床功能评估[JOA、颈椎功能障碍指数(NDI)]以及FA值之间的相关性。结果左侧颞中回DC值在HC组、CSM轻中度组及重度组表现为逐步升高,且重度组明显高于轻中度组、HC组(P<0.05);重度组右侧楔前叶DC值明显低于轻中度组、HC组(P<0.05),重度组右侧颞上回DC值明显低于轻中度组(P<0.05)。C2、3水平脊髓纤维束FA值随脊髓结构损害严重程度进行性减低,重度组最低,明显低于轻中度组和HC组(P<0.05)。CSM患者异常区域DC值与临床功能评分无明显相关性(P>0.05),背索FA值与JOA评分呈正相关(r=0.358,P<0.05)。结论CSM患者存在大脑功能重塑;DC可能是评估CSM患者病情的定量影像指标。
Objective To analyze the relevant mechanism of inconsistencies between the imaging manifestations and clinical symptoms of cervical spondylotic myelopathy(CSM)by observing the damage of cervical spinal cord structural and brain functional remodeling in patients with CSM.Methods We recruited 40 patients with CSM(22 mild-moderate CSM,18 severe CSM),and 25 healthy controls(HCs)matched for age,sex and education status.Spinal DTI(level C2/3)with FA and cerebral fMRI were acquired on a 3.0 T MR Scanner,Pearson correlation analysis was then performed.Results Compared with HCs,the two CSM groups showed gradually increased DC in the left middle temporal gyrus,the severe group was higher than the mild-moderate group and HCs(P<0.05).Decreased DC in the right precuneus and superior temporal gyrus were found in the severe CSM group,which was significantly lower than the mild-moderate group(P<0.05).With the severity of cervical spinal cord structural damage,the FA value(level C2/3)of spinal fiber tracts progressively decreased,and the severe CSM group was found to be significantly lower than that of the mild-moderate CSM group and HCs(P<0.05).There was no significant correlation between DC values of abnormal region and clinical function score of CSM patients(P>0.05),while FA value of dorsal cord was positively correlated with JOA score(r=0.358,P<0.05).Conclusion Remodeling of brain function was found in patients with CSM and DC may be a quantitative imaging indicator to evaluate the condition of CSM.
作者
吴开富
刘萌
何来昌
谭永明
WU Kaifu;LIU Meng;HE Laichang(Department of Radiology,The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi Province 330006,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第12期2364-2369,共6页
Journal of Clinical Radiology
基金
国家自然科学基金地区科学基金项目(编号:81460329)
江西省自然科学基金资助项目(编号:20192ACBL20039、20181BAB205063)
关键词
脊髓型颈椎病
静息态功能磁共振成像
度中心度
Cervical spondylotic myelopathy
Resting-state functional magnetic resonance imaging
Degree centrality
作者简介
通讯作者:谭永明
