本文選題：原發(fā)性閉角型青光眼　切入點(diǎn)：靜息態(tài)功能磁共振　出處：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:本研究應(yīng)用靜息態(tài)功能磁共振(resting-state functional MRI,rs-fMRI)技術(shù)研究原發(fā)性閉角型青光眼(primary angle-closure glaucoma,PACG)患者小梁網(wǎng)聯(lián)合周邊虹膜切除手術(shù)前后初級(jí)視覺(jué)皮層(primary visual cortex,V1)功能連接的變化情況,旨在為PACG患者術(shù)前中樞損害機(jī)制提供功能影像證據(jù)及提高對(duì)其術(shù)后功能重塑的認(rèn)識(shí)。方法:收集臨床確診的手術(shù)前PACG患者(pre-PACG組)及年齡、性別相匹配的健康對(duì)照組(HCs組)進(jìn)行3T磁共振T1結(jié)構(gòu)像及靜息態(tài)血氧水平依賴(lài)功能磁共振(BOLD-fMRI)掃描,最終納入pre-PACG組和HCs組各25例進(jìn)行rs-fMRI分析,其中9例PACG患者手術(shù)后3個(gè)月(post-PACG組)復(fù)查rs-fMRI。數(shù)據(jù)經(jīng)預(yù)處理后,以左、右側(cè)V1中心區(qū)作為種子點(diǎn),分別計(jì)算其與全腦體素時(shí)間序列的相關(guān)性并比較組間靜息態(tài)功能連接的差異,pre-PACG組與HCs組組間差異采用兩獨(dú)立樣本t檢驗(yàn),采用配對(duì)樣本t檢驗(yàn)分析post-PACG組與pre-PACG組組間差異。同時(shí),分析pre-PACG組顯著差異腦區(qū)功能連接系數(shù)與其臨床變量的相關(guān)性。結(jié)果:1、與HCs組相比,pre-PACG組與左側(cè)V1功能連接減低的腦區(qū)包括右側(cè)高級(jí)視覺(jué)皮層(V2,包括右側(cè)楔葉,距狀皮層、舌回)和右側(cè)后扣帶回。與左側(cè)V1功能連接增強(qiáng)的腦區(qū)包括左側(cè)顳頂區(qū),左側(cè)及右側(cè)島蓋-腦島-基底節(jié)區(qū),及右側(cè)頂下小葉。2、與pre-PACG組相比,post-PACG組與左側(cè)V1功能連接增強(qiáng)的腦區(qū)包括雙側(cè)V2(左側(cè)楔前葉,楔葉,右側(cè)枕上回),左側(cè)及右側(cè)中央后回,頂下小葉。而左側(cè)前額葉皮層及右側(cè)小腦后葉與左側(cè)V1功能連接減低。3、在Pre-PACG組,左側(cè)顳頂區(qū)與左側(cè)V1功能連接與視敏度(Visual acuity,VA)呈正相關(guān),右側(cè)頂下小葉與左側(cè)V1功能連接與VA呈正相關(guān)。4、在pre-PACG和post-PACG患者,右側(cè)V1功能連接改變與左側(cè)V1功能連接改變模式基本相同。結(jié)論:1、與正常對(duì)照者相比,PACG患者存在初-高級(jí)視覺(jué)皮層通路視覺(jué)信息功能整合的下降,同時(shí)存在與視敏度相關(guān)的功能代償。為進(jìn)一步理解PACG患者的中樞損害機(jī)制提供思路。2、與術(shù)前相比,PACG患者術(shù)后表現(xiàn)出初-高級(jí)視覺(jué)皮層通路視覺(jué)信息整合功能的增加,可能為局部腦功能重塑。為探索PACG患者的術(shù)后腦功能轉(zhuǎn)歸提供線索。
[Abstract]:Objective: to study the changes of functional junctions of primary visual cortexus V1 in primary angle-closure glaucoma patients before and after primary angle-closure glaucoma.com (PACGG), using resting functional magnetic resonance imaging (resting-state functional MRIr rs-f MRI) technique. The purpose of this study was to provide functional imaging evidence for preoperative central nervous system damage in patients with PACG and to improve their understanding of functional remodeling after operation. Methods: the pre-PACG patients with pre-PACG were collected and their ages were collected. Sex matched healthy control group (HCs group) were examined by 3T Mr T1 structure imaging and resting blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI), and 25 cases in pre-PACG group and 25 cases in HCs group were included in rs-fMRI analysis. In 9 patients with PACG, after 3 months post-PACG), the data of rs-f MRI. were pretreated, and the left and right central V1 regions were used as seed points. To calculate the correlation with the whole brain voxel time series and to compare the differences of resting functional junctions between pre-PACG group and HCs group, two independent samples t test were used to analyze the difference between post-PACG group and pre-PACG group by paired sample t-test, and the difference between pre-PACG group and pre-PACG group was analyzed. Results: compared with HCs group, the decreased functional connectivity between pre-PACG group and left V1 group included V2 in the right advanced visual cortex, including right cuneate lobe and talar cortex. The right posterior cingulate gyrus and the right posterior cingulate gyrus. The regions with enhanced V1 function include the left temporal parietal region, the left and right insular tectone-insular insular basal ganglia, and the right posterior cingulate gyrus. Compared with the pre-PACG group, the right inferior parietal lobule. The areas in which the functional connections between post-PACG group and left V1 were enhanced included bilateral V2 (left precuneal lobe, cuneiform lobe, right superior occipital gyrus, left and right posterior central gyrus). In the Pre-PACG group, the functional connections between the left temporoparietal region and the left V1 were positively correlated with visual acuity. The right inferior parietal lobule and left V1 functional connection were positively correlated with VA. 4, in pre-PACG and post-PACG patients, The changes of right V1 functional connections were similar to those of left V1 functional connections. Conclusion: compared with the normal controls, the visual information integration of the primary and advanced visual cortex pathway decreased in the patients with PACG, and the changes of the right V1 functional connections were similar to those of the left V1 functional connections. At the same time, there are functional compensations related to visual acuity. 2. To further understand the mechanism of central lesion in PACG patients, compared with preoperative and postoperative patients, the visual information integration function of primary and advanced visual cortex pathway is increased. It may provide clues for local brain function remodeling and for exploring the outcome of postoperative brain function in patients with PACG.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R445.2;R779.6

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