Page 101 - 磁共振成像2024年7期电子刊

临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

基于TBSS方法对急性轻度创伤性脑损伤患者

脑白质改变的扩散峰度成像研究

郭冉，信瑞强，石逸杰，钟佳利，杨宏宇，彭如臣 *

作者单位 首都医科大学附属北京潞河医院放射科，北京 101149
* 通信作者 彭如臣，E-mail: pengruchen@ccmu.edu.cn
中图分类号 R445.2；R651.1 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.016
本文引用格式 郭冉, 信瑞强, 石逸杰, 等 . 基于 TBSS方法对急性轻度创伤性脑损伤患者脑白质改变的扩散峰度成像研究[J]. 磁共
振成像, 2024, 15(7): 94-98.
[摘要] 目的 采用扩散峰度成像（diffusion kurtosis imaging, DKI）研究急性轻度创伤性脑损伤（mild traumatic brain injury,
mTBI）患者脑白质微结构的变化特点，探讨 DKI在 mTBI患者的临床应用价值。材料与方法 分析 2018年 1月至 12月于我院就
诊的 27例 mTBI患者和性别、年龄、受教育年限相匹配的 27例健康志愿者的临床及 DKI影像数据，采用基于纤维束示踪的空间
统计分析 （tract-based spatial statistics, TBSS） 方法分析 mTBI 组和对照组存在差异的脑区及其各向异性分数 （fractional
anisotropy, FA）值、平均峰度（mean kurtosis, MK）值、轴向峰度（axial kurtosis, AK）值、径向峰度（radial kurtosis, RK）值、
峰度各向异性（kurtosis fractional anisotropy, KFA）值。结果 mTBI 组左侧上纵束-颞叶部 FA 值（0.450±0.048）低于对照组
（0.480±0.028，t=−2.253，P=0.028 5）；mTBI 组胼胝体辐射线枕部 AK 值（0.68±0.05）低于对照组（0.72±0.05，t=−2.407，P=
0.019 7）；mTBI 组右侧扣带束海马部 RK 值（0.89±0.15）低于对照组（0.99±0.18，t=−2.044，P=0.046 0）；mTBI 组右侧丘脑前
辐射、右侧扣带束的扣带皮层部、右侧下额枕束、右侧下纵束、右侧上纵束-颞叶部 KFA值[（0.49±0.19）、（0.50±0.32）、（0.48±
0.30）、（0.49±0.03）、（0.54±0.59）]均低于对照组[（0.51±0.13）、（0.52±0.20）、（0.50±0.02）、（0.51±0.26）、（0.57±0.46），t=
−2.15、−2.95、−2.37、−2.38、−2.25，P 均<0.05]；mTBI 组 MK 值与对照组相比差异无统计学意义（P>0.05）。结论 DKI 参数
可作为评估急性mTBI患者脑白质改变的神经影像生物标志物，可揭示脑白质微结构的微小变化。
[关键词] 创伤性脑损伤；磁共振成像；扩散峰度成像；基于纤维束示踪的空间统计分析；峰度各向异性
Diffusion kurtosis imaging of brain white matter alteration in patients with acute mild traumatic
brain injury based on the TBSS method

GUO Ran, XIN Ruiqiang, SHI Yijie, ZHONG Jiali, YANG Hongyu, PENG Ruchen *
Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
* Correspondence to PENG R C, E-mail: pengruchen@ccmu.edu.cn
Received 16 Dec 2023, Accepted 12 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.016
ACKNOWLEDGMENTS Key Specialized Cultivation Projects for Major Epidemic Prevention and Control in Beijing in 2021 [No.
Beijing Municipal Health Bureau (2021) No. 135]; Beijing Tongzhou District Science and Technology Project (No. KJ2018CX009-05).
Cite this article as GUO R, XIN R Q, SHI Y J, et al. Diffusion kurtosis imaging of brain white matter alteration in patients with acute
mild traumatic brain injury based on the TBSS method[J]. Chin J Magn Reson Imaging, 2024, 15(7): 94-98.
Abstract Objective: Diffusion kurtosis imaging (DKI) was used to study the white matter microstructure changes in mild traumatic
brain injury (mTBI) patients, so as to explore the clinical application value of DKI in mTBI patients. Materials and Methods: The
clinical and DKI data of 27 mTBI patients who were diagnosed in our hospital and 27 healthy control subjects matched in gender, age,
and years of education recruited from January to December 2018 were analyzed. Using the tract-based spatial statistics (TBSS) method to
analyze the differences in brain regions and their fractional anisotropy (FA) value, mean kurtosis (MK) value, axial kurtosis (AK) value,
radial kurtosis (RK) value, and kurtosis fractional anisotropy (KFA) value between the mTBI patients subjects and the control subjects.
Results: The FA value of the left superior longitudinal fasciculus (temporal part) was lower in mTBI patients (0.450±0.048) than that in
the control subjects (0.480±0.028, t=−2.253, P=0.028 5). The AK value of the forceps major was lower in mTBI patients (0.68±0.05)
than that in the control subjects (0.72±0.05, t=−2.407, P=0.019 7). The RK value of the right cingulum (hippocampus) was lower in
mTBI patients (0.89±0.15) than that in the control subjects (0.99±0.18, t= − 2.044, P=0.0 460). The KFA values of the right anterior
thalamic radiation, the right cingulum (cingulate gyrus), the right inferior fronto-occipital fasciculus, the right inferior longitudinal
fasciculus, and the right superior longitudinal fasciculus (temporal part) were lower in mTBI patients [(0.49±0.19), (0.50±0.32), (0.48±
0.30), (0.49±0.03), and (0.54±0.59)] than that in the control subjects[(0.51±0.13), (0.52±0.20), (0.50±0.02), (0.51±0.26), and (0.57±0.46),
t=−2.15, −2.95, −2.37, −2.38, and −2.25, respectively,all P＜0.05]. However, there was no statistically significant difference in MK
values between the subjectss (P>0.05). Conclusions: The DKI parameter serves as a neuroimaging biomarker for assessing brain white
matter alterations in patients with acute mTBI, capable of unveiling minute variations in white matter microstructure.
Key words traumatic brain injury; magnetic resonance imaging; diffusion kurtosis imaging; tract-based spatial statistics; kurtosis
fractional anisotropy

0 引言 mTBI）是一个重大的公共卫生问题，约占所有 TBI患
轻度创伤性脑损伤（mild traumatic brain injury, 者的70%~90% [1-2] 。mTBI可导致头痛、抑郁、认知障碍

收稿日期 2023-12-16 接受日期 2024-07-12
基金项目 2021年度北京市重大疫情防治重点专科培育类项目（编号：京卫医〔2021〕135 号）；北京市通州区科技计划项目（编号：
KJ2018CX009-05）

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