Conventional and advanced brain MR imaging in patients with sickle cell anemia.
Conventional and advanced brain MR imaging in patients with sickle cell anemia.
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DOI：
10.4103/ijri.ijri_166_17
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Issar SK
中科院分区：
文献类型：
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作者：
Issar P;Nehra M;Singh G;Issar SK
镰状细胞病是一种常染色体隐性遗传性溶血性疾病，其脑血管并发症包括无症状性脑缺血、脑梗塞和脑萎缩。常规磁共振成像(MRI)往往低估了损伤的程度。弥散张量成像(DTI)可以显示和量化常规MRI正常的SCD患者的脑微结构改变。目的：用常规MRI检查无症状镰状细胞患者的各种神经系统异常，并用弥散张量成像(DTI)评价脑内不同区域的微结构。一项前瞻性、随机化的病例对照研究进行了两年。共纳入58例SCD患者和56例年龄和性别匹配的对照组。两组患者均按标准方案进行常规MRI和DTI检查。计算了某些预定区域的分数各向异性(FA)和表观扩散系数(ADC)。原始数据用MS EXCEL版本17进行分析，经方差检验，统计学意义设为P<；0.05。最终分析包括30个感兴趣的区域，60个变量。SCD患者FA值降低，ADC值升高，或两者兼有，聚集在几个脑区，包括脑桥、脑脚、穹隆、额叶、颞叶、顶叶白质、半卵圆中心、脑室周围区、基底节和左侧丘脑(P<；0.05)。当常规MRI正常时，DTI是表征微结构改变的一种有前途的方法。
Sickle cell disease (SCD) is an autosomal recessive hemolytic disorder; its cerebrovascular complications include silent cerebral ischemia, infarct, and brain atrophy. Conventional magnetic resonance imaging (MRI) often underestimates the extent of injury. Diffusion tensor imaging (DTI) can demonstrate and quantify microstructural brain changes in SCD cases having normal routine MRI. To identify various neurological abnormalities in asymptomatic sickle cell patients using routine MRI and to evaluate the microstructure of various regions of the brain using DTI. A prospective, randomized case–control study was conducted over a period of 2 years. A total of 58 cases of SCD and 56 age- and sex-matched controls were included. Routine MRI and DTI were performed in both the groups following a standard protocol. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated in certain pre-defined regions. Primary data were analyzed using MS excel version 17. Analysis of variance test was performed and statistical significance was set at P < 0.05. Thirty regions of interest with 60 variables were included in the final analysis. Patients with SCD showed statistically significant reduced FA values, increased ADC values, or both, clustered in several brain areas, including pons, cerebral peduncle, corpus callosum, frontal, temporal, parietal white matter, centrum semiovale, periventricular areas, basal ganglia, and left thalamus (P < 0.05). DTI is a promising method for characterizing microstructural changes, when conventional MRI is normal.