【摘要】：目的：利用3.0T超高場強靜息態(tài)血氧水平依賴功能磁共振成像（Blood-oxygenlevel dependent fMRI, BOLD-fMRI）和擴散張量成像（Diffusion tensor imaging,DTI）技術，研究慢性高原�。–hronic Mountain Sickness, CMS）患者自發(fā)腦活動特征和白質結構特征，探討慢性缺氧對腦結構和功能的影響。 研究方法：對13例臨床確診的CMS患者和12例性別、年齡、受教育程度及居住海拔高度相匹配的正常自愿者（對照組）進行靜息態(tài)BOLD和DTI磁共振成像掃描。采用局部一致性（Regional Homogeneity, ReHo）方法處理BOLD數(shù)據(jù)，對CMS組和對照組靜息態(tài)下大腦的自發(fā)活動進行對比分析。采用基于纖維束的空間統(tǒng)計方法（Tract-Based Spatial Statistics,TBSS）分析DTI數(shù)據(jù)，計算CMS組和對照組腦白質的各向異性參數(shù)（包括部分各向異性（FractionalAnisotropy,FA）、平均彌散系數(shù)（Mean Diffusivit, MD）、軸向彌散系數(shù)（Axial diffusivity, AD）和徑向彌散系數(shù)（Radial diffusivity, RD））。采用基于體素的單樣本t檢驗對BOLD組內(nèi)數(shù)據(jù)進行比較，采用基于體素的兩樣本t檢驗進行BOLD數(shù)據(jù)的組間比較。采用基于體素的兩樣本t檢驗進行DTI數(shù)據(jù)的組間比較。 結果：1.ReHo分析結果：①在靜息狀態(tài)下CMS組和對照組都表現(xiàn)出多個腦區(qū)激活，分布區(qū)域大體一致，但CMS組總體的局部神經(jīng)元活動一致性程度比對照組相對降低；②與對照組相比，CMS組在雙側顳下回、右側梭狀回和左側額中回ReHo減低，在左側海馬旁回、左側中央后回ReHo增高，差異有統(tǒng)計學意義（p0.01，，alphasim校正）。2.DTI分析結果：①與對照組比較，CMS組在小腦表現(xiàn)出較低的MD（p0.01，未校正），在小腦和胼胝體壓部表現(xiàn)出較低的AD（p0.01，未校正）；②與對照組相比，CMS組無任何腦區(qū)表現(xiàn)出明顯增高的FA、MD、AD和RD（p 0.01，未校正）。 結論：CMS組和對照組在靜息狀態(tài)下大腦局部一致性存在一定的差異；兩組之間大腦白質的各向異性參數(shù)也存在特異性差異，這些結構和功能的差異可以幫助我們深入地了解慢性缺氧對大腦的影響。
[Abstract]:Objective: to study the characteristics of spontaneous brain activity and white matter structure in patients with chronic high altitude disease (Chronic Mountain Sickness, CMS) by using 3.0T ultra-high field resting blood oxygen level dependent functional magnetic resonance imaging (Blood-oxygenlevel dependent fMRI, BOLD-fMRI) and diffusion imaging (Diffusion tensor imaging,DTI). To investigate the effect of chronic hypoxia on brain structure and function. Methods: 13 patients with clinically diagnosed CMS and 12 normal volunteers (control group) matched with sex, age, education level and residence altitude were scanned by resting BOLD and DTI MRI. Local consistent (Regional Homogeneity, ReHo) method was used to process BOLD data and the brain spontaneous activity in CMS group and control group was analyzed. The spatial statistical method based on fiber bundle (Tract-Based Spatial Statistics,TBSS) was used to analyze DTI data. Calculate the anisotropic parameters of white matter (including partial anisotropy (FractionalAnisotropy,FA), mean diffusion coefficient (Mean Diffusivit, MD), axial diffusion coefficient (Axial diffusivity, AD) and radial diffusion coefficient (Radial diffusivity, RD).) of white matter in CMS group and control group) A single sample t test based on voxel was used to compare the data in BOLD group and two samples t test based on voxel was used to compare BOLD data between groups. Two samples t test based on voxel were used to compare DTI data. Results: the results of 1.ReHo analysis were as follows: (1) in the rest state, the CMS group and the control group showed multiple brain activation, and the distribution areas were roughly the same, but the consistency degree of the local neuronal activity in the CMS group was lower than that in the control group. 2Compared with the control group, ReHo in bilateral infratemporal gyrus, right fusiform gyrus and left middle frontal gyrus decreased in CMS group, but increased in left parahippocampal gyrus and left postcentral gyrus. The results of 2.DTI analysis were as follows: 1 compared with control group, CMS group showed lower MD in cerebellum (p0.01, uncorrected), lower AD in cerebellum and corpus callosum (p0.01, uncorrected); 2 compared with the control group, there was no significant increase in FA,MD,AD and RD (p in the CMS group. Conclusion: there are some differences between the CMS group and the control group in the regional consistency of the brain, the anisotropy parameters of the white matter in the brain are also different between the two groups, and there is also a specific difference between the two groups. These differences in structure and function can help us understand the effects of chronic hypoxia on the brain.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R594.3

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