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400037 重庆,陆军军医大学(第三军医大学)第二附属医院神经外科
[杨小林,E-mail: yangxl2013@163.comYANG Xiaolin, E-mail: yangxl2013@163.com
收稿:2020-03-05,
修回:2020-03-24,
纸质出版:2020-07-30
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张晓青, 杨小林. 肢端肥大症患者脑灰质厚度改变的磁共振成像研究[J]. 第三军医大学学报, 2020,42(14):1428-1433.
Xiaoqing ZHANG, Xiaolin YANG. Alteration of cerebral gray matter thickness in acromegaly: a magnetic resonance imaging study[J]. Journal of Third Military Medical University, 2020, 42(14): 1428-1433.
张晓青, 杨小林. 肢端肥大症患者脑灰质厚度改变的磁共振成像研究[J]. 第三军医大学学报, 2020,42(14):1428-1433. DOI: 10.16016/j.1000-5404.202003066.
Xiaoqing ZHANG, Xiaolin YANG. Alteration of cerebral gray matter thickness in acromegaly: a magnetic resonance imaging study[J]. Journal of Third Military Medical University, 2020, 42(14): 1428-1433. DOI: 10.16016/j.1000-5404.202003066.
目的
2
应用基于脑表面分析(surface based analysis
SRA)的方法研究肢端肥大症患者磁共振脑结构图像,分析肢端肥大症患者各脑区灰质厚度的改变以及与临床资料的相关性。
方法
2
收集2015年1月27日至2019年6月30日我科30名肢端肥大症患者和30名健康成年人磁共振三维容积扰相梯度回波(three dimensions T1 spoiled gradient recalled
3D T1-SPGR)薄层扫描图像,运用Freesurfer软件进行分析,得出所有大脑灰质厚度数据,并进行对比分析,得到差异脑区,分析其与临床资料的相关性。
结果
2
与健康对照相比,肢端肥大症患者右侧额中回下部、右侧额中回上部、右侧中央前回、右侧缘上回、右侧楔前叶、右侧海马旁回、右侧梭状回和左侧内嗅皮层灰质厚度变薄,且右侧楔前叶和右侧海马旁回灰质厚度与汉密尔顿抑郁量表(Hamilton Depression Scale
HAMD)评分呈负相关,与血浆高水平生长激素(growth hormone
GH)和胰岛素样生长因子-1(insulin-like growth factor-1
IGF-1)水平呈负相关,灰质厚度变化与年龄无相关性。
结论
2
肢端肥大症患者存在多个脑区灰质厚度的变薄,可能是高水平的GH和IGF-1激素作用所致,其中右侧楔前叶和右侧海马旁回灰质厚度变薄与肢端肥大症患者抑郁症有关。
Objective
2
To study the changes of cortical thickness in different brain regions in patients with acromegaly using surface-based analysis (SRA) and analyze the association of these changes with clinical findings of the patients.
Methods
2
Thirty patients with acromegaly and 30 healthy adults underwent magnetic resonance imaging (MRI) examination using a T1-weighted three-dimensional spoiled gradient recalled (3D SPGR) sequence. The MRI images were analyzed using Freesurfer software to determine the changes of cortical thickness in different brain regions of the patients relative to those in the healthy subjects
and the correlation of these changes with the clinical findings of the patients were analyzed.
Results
2
Compared with the healthy subjects
acromegalic patients had decreased cortical thickness in the right rostral middle frontal gyrus
the right caudal middle frontal gyrus
the right precentral gyrus
the right supramarginal gyrus
the right precuneus
the right parahippocampal gyrus
the right fusiform gyrus and the left olfactory cortex thickness. The cortical thickness in the right precuneus and the right parahippocampal gyrus were inversely correlated with Hamilton Depression Scale (HAMD) scores and levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) but were not correlated with age of the patients.
Conclusion
2
The patients with acromegaly have decreased cortical thickness in multiple brain regions
possibly as a result of high levels of GH and IGF-1. The decreased cortical thickness in the right precuneus and the right parahippocampal gyrus is correlated with depression in acromegalic patients.
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