發(fā)布時(shí)間：2018-05-09 23:06

  本文選題：視覺(jué)通路 + 原發(fā)性青光眼　； 參考：《大連醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:采用磁共振成像技術(shù)研究原發(fā)性青光眼視覺(jué)傳導(dǎo)通路(visual pathway)各部分的變化趨勢(shì),探討視覺(jué)通路的變化與臨床分型的相關(guān)性,以及視覺(jué)通路各部分變化程度的相關(guān)性。 方法:本研究選擇雙眼原發(fā)性慢性青光眼患者20例(男10例,女10例;年齡范圍24-72歲,平均年齡50.90±14.69歲),依據(jù)臨床病理分型分為原發(fā)性開角型青光眼(primary open angle glaucoma,POAG)組及原發(fā)性閉角型青光眼(primary angle-closure glaucoma,PACG)組。所有受試者均行顱腦磁共振彌散張量成像(diffusion tensor imaging,DTI)及冠狀位質(zhì)子密度加權(quán)像(proton density weighted image,PDWI)掃描,手工測(cè)量視神經(jīng)(optic nerve)、視束(optic tract)及視輻射(optic radiation)的部分各向異性(fractional anisotropy,FA)值、平均彌散系數(shù)(average diffusion coefficient,DCavg)及外側(cè)膝狀體(lateral geniculate body,LGN)的高度和體積。并對(duì)照正常成人健康志愿者18例(男8例,女10例,年齡范圍25~69歲,平均年齡45.7±15.3歲)相同指標(biāo)的測(cè)量結(jié)果,利用SPSS17.0軟件,采用單因素方差分析來(lái)分析原發(fā)性青光眼患者視覺(jué)通路相較健康人的變化情況,及原發(fā)性青光眼不同臨床病理分型組間的差異,對(duì)健康人和原發(fā)性青光眼組雙側(cè)視神經(jīng)、視束、視放射的平均FA值及DCavg值與雙側(cè)外側(cè)膝狀體高度及體積進(jìn)行Pearson相關(guān)性分析,取p0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果: POAG左、右側(cè)視神經(jīng)FA值均明顯降低(p0.001,p 0.001),DCavg值明顯升高(p =0.01,p =0.003);左、右側(cè)視束FA值明顯降低(p 0.001,p 0.001),DCavg值明顯升高(p 0.001,p 0.001);左、右側(cè)視輻射FA值明顯降低(p 0.001,p 0.001),DCavg值未見(jiàn)明顯差異(p =0.328,p=0.270);左、右側(cè)LGN體積明顯減小(p0.001,p0.001),高度明顯減小(p0.001,p0.001)。PACG左、右側(cè)視神經(jīng)FA值均明顯降低(p0.001,p0.001),DCavg值明顯升高(p=0.043,p=0.029);左、右側(cè)視束FA值明顯降低(p0.001,p0.001),DCavg值明顯升高(p=0.004,p=0.017);左、右側(cè)視輻射FA值明顯降低(p0.001,p0.001),DCavg值明顯升高(p=0.039,p=0.004);左、右側(cè)LGN體積明顯減小(p0.001,p0.001),高度明顯減小(p0.001,p0.001)。POAG與PACG右側(cè)LGN高度有統(tǒng)計(jì)學(xué)差異(p=0.016),POAG組的LGN均值略高(4.267±0.646mm)。原發(fā)性青光眼左側(cè)視輻射FA值與左側(cè)LGN體積呈正相關(guān)(r=0.512,p=0.021),左、右側(cè)視神經(jīng)DCavg值分別與右側(cè)LGN體積的變化存在一定程度的正相關(guān)(r=0.523,p=0.018;r=0.449,p=0.047)。 結(jié)論:本研究證實(shí)了原發(fā)性開角型青光眼及原發(fā)性閉角型青光眼視神經(jīng)、視束、視輻射、外側(cè)膝狀體均有不同程度的退變性改變,且聯(lián)合應(yīng)用磁共振彌散張量成像及磁共振質(zhì)子密度加權(quán)成像可以為視覺(jué)通路顯微結(jié)構(gòu)的顯示和病理狀態(tài)的評(píng)估提供有價(jià)值的信息。
[Abstract]:Objective: To study the changes in the visual pathway of primary glaucoma (visual pathway) by magnetic resonance imaging (MRI), and to explore the correlation between the changes of the visual pathway and the clinical typing and the degree of changes in the various parts of the visual pathway.
Methods: 20 cases of primary chronic glaucoma (10 males and 10 females, 24-72 years of age, with an average age of 50.90 + 14.69 years old) were selected and divided into groups of primary open angle glaucoma (primary open angle glaucoma, POAG) and primary angle closure glaucoma (primary angle-closure glaucoma, PACG) according to the clinicopathological classification. All subjects underwent diffusion tensor imaging (DTI) and coronary position proton density weighted imaging (proton density weighted image, PDWI), and the manual measurement of optic nerve (optic nerve), the partial anisotropy of the optic tract (optic) and visual radiation. The height and volume of the mean dispersion coefficient (average diffusion coefficient, DCavg) and the lateral geniculate body (lateral geniculate body, LGN) were measured in 18 normal adult healthy volunteers (male 8, female 10, age 25~69, and average age 45.7 + 15.3 years old). Analysis of the changes of visual pathways in primary glaucoma patients and the difference between different types of clinicopathological groups in primary glaucoma, the average FA value and DCavg value of bilateral optic nerve, optic tract, optic radiation and bilateral lateral geniculate body in healthy people and primary glaucoma group were related to Pearson correlation. Analysis, P0.05 has statistical significance.
Results: POAG left, right optic nerve FA value decreased significantly (p0.001, P 0.001), DCavg value increased significantly (P =0.01, P =0.003), left, right optic tract FA value decreased significantly (P 0.001, P 0.001), the value significantly increased (0.001, 0.001); left, apparent 0.001, 0.001, there was no significant difference (0.001, 0.001); left, left, left, The right LGN volume decreased significantly (p0.001, p0.001), the height decreased significantly (p0.001, p0.001).PACG left, and the FA value of the right optic nerve decreased significantly (p0.001, p0.001), the DCavg value increased significantly (p=0.043, p=0.029), and left, the value of the right visual tract obviously increased. 0.001, p0.001), the value of DCavg increased significantly (p=0.039, p=0.004), and the left, right LGN volume decreased significantly (p0.001, p0.001), and the height significantly decreased (p0.001, p0.001).POAG and PACG LGN height (4.267). =0.512, p=0.021). The DCavg values of left and right optic nerves were positively correlated with the LGN volume of the right side (r=0.523, p=0.018, r=0.449, p=0.047).
Conclusion: This study confirms that the optic nerve, optic tract, optic radiation, and lateral geniculate body have varying degrees of degeneration in primary open angle glaucoma and primary angle closure glaucoma, and the combination of magnetic resonance diffusion tensor imaging and magnetic resonance proton density weighted imaging can be the display and pathological state of the visual pathway microstructures. The assessment provides valuable information.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R445.2;R775

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本文編號(hào)：1867821