摘要
目的通过扩散张量成像(DTI)评价脊髓性肌萎缩(SMA)患儿大腿肌肉的微观结构改变,分析DTI定量参数与临床指标的相关性,以探讨DTI评估SMA疾病严重程度的临床价值。方法前瞻性搜集30例经基因确诊的SMA患儿(Ⅱ型16例,Ⅲ型14例),行双侧大腿肌肉常规MRI及DTI,测量右侧大腿13块肌肉DTI定量参数[各向异性分数(FA)、表观扩散系数(ADC)],并搜集患儿的临床指标[年龄、体质量指数(BMI)及Hammersmith运动功能量表(HFMSE)评分]。采用Spearman秩相关性分析DTI定量参数与临床指标的相关性,采用独立样本的非参数检验比较Ⅱ、Ⅲ型患者的组间差异。结果股薄肌的平均FA值最大和ADC值最小,长收肌的平均FA值最小和ADC值最大;患儿大腿肌肉的平均FA值与HFSME评分呈负相关,平均ADC值与HFSME评分呈正相关。Ⅱ型SMA患儿大腿肌肉的平均FA值高于Ⅲ型,而平均ADC值低于Ⅲ型,差异均具有统计学意义。结论DTI能客观有效地定量评估SMA患儿疾病的严重程度,并有助于区分Ⅱ、Ⅲ型SMA,在监测疾病进程、评价治疗效果方面有重要临床应用价值。
Objective To evaluate the microstructural changes of lower limb muscles in children with spinal muscular atrophy(SMA)by magnetic resonance diffusion tensor imaging(DTI),and to analyze the correlation between diffusion metrics and clinical assessments,in order to explore the clinical value of DTI in assessing the severity of SMA.Methods Thirty children(14 type II and 16 type II)with SMA diagnosed by gene were prospectively collected,and they performed lower limb routine MRI and DTI.FA and ADC values of 13 muscles of right lower limb were measured.Clinical data(including age,body mass index(BMI)and,Hammersmith Motor Function Scale(HFMSE)score)were also collected.Spearman's rank correlation was used to analyze the correlation between muscle FA and ADC values and clinical data,and non-parametric tests for independent samples were used to compare age,BMI,muscle FA values,ADC values between type II and type II.Results The average FA value of gracilis muscle is the highest and the ADC value is the lowest.The average FA value of adductor longus muscle is the lowest and the ADC value is the largest.The mean FA value of thigh muscle was negatively correlated with HFSME score,and the mean ADC value was positively correlated with HFSME score.The mean FA value of lower limb muscles in children with type II SMA was higher than that of type II,and the average ADC value of lower limb muscles in children with type II SMA was lower than that of type II,and the differences were statistically significant.Conclusion DTI can objectively and effectively quantitatively evaluate the severity of SMA in children,and can distinguish type I and type II SMA.It has important clinical value in monitoring the disease process and evaluating the therapeutic effect.
作者
黄杨
方雪琳
陈太雅
陈嘉坤
路新国
方佃刚
罗益镇
孟宪磊
麦嘉卉
李志勇
HUANG Yang;FANG Xuelin;CHEN Taiya(Medical College of Shantou University,Shantou,Guangdong Province 515000,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第11期1784-1788,共5页
Journal of Clinical Radiology
基金
深圳市医疗卫生三名工程项目(编号:SZSM202011005)。
关键词
扩散张量成像
肌肉
脊髓性肌萎缩
定量成像
Diffusion tensor imaging
Muscle
Spinal muscularatrophy
Quantitative imaging
