Diffusion tensor magnetic resonance imaging reveals visual pathway damage that correlates with clinical severity in glaucoma
Diffusion tensor magnetic resonance imaging reveals visual pathway damage that correlates with clinical severity in glaucoma
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DOI：
10.1111/j.1442-9071.2012.02832.x
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发表时间：
2013-01-01
影响因子：
4
通讯作者：
Zhang, Hong
中科院分区：
文献类型：
--
作者：
Chen, Zhiqi;Lin, Fuchun;Zhang, Hong
背景资料：采用弥散张量成像的基于束的空间统计分析研究原发性开角型青光眼患者视路神经纤维损伤，并将这些测量与青光眼的临床严重程度相关联。设计：横断面研究。参与者：招募了25名原发性开角型青光眼患者和24名健康对照者。研究方法：所有受试者均接受详细的眼科检查，包括杯盘比、视网膜神经纤维层厚度和视野检查。使用3.0 T磁共振扫描仪进行视路扩散张量成像。主要观察指标：通过基于视束的空间统计分析计算视路神经纤维的扩散率变化。评估平均扩散率和各向异性分数，并与眼科测量结果进行比较。结果如下：与对照组相比，原发性开角型青光眼患者的双侧视束和视辐射的各向异性分数显著降低，平均扩散率显著增加（P < 0.05）。青光眼组视束各向异性分数和视辐射各向异性分数分别与杯盘比、视网膜神经纤维层厚度和视功能分析一致（P < 0.05）。视神经束的平均扩散率与这些眼科测量值相关（P < 0.05）。而视辐射的平均扩散率与眼科测量值之间无显著相关性（P > 0.05）。结论：原发性开角型青光眼患者的视神经束和视放射线显示神经变性的影像学证据。这随着视神经盘的损伤和视功能的丧失而变化。弥散张量成像的基于道的空间统计分析是检测原发性开角型青光眼皮质神经纤维丢失的客观有效工具。
Background: To investigate nerve fibre damage of the visual pathway in patients with primary open-angle glaucoma using tract-based spatial statistical analysis of diffusion tensor imaging and correlate these measures with the clinical severity of glaucoma. Design: Cross-sectional study. Participants: Twenty-five individuals with primary open-angle glaucoma and 24 healthy controls were recruited. Methods: All subjects underwent detailed ophthalmological examinations, including the cup-to-disc ratio, retinal nerve fibre layer thickness and visual fields test. Diffusion tensor imaging of the visual pathway was performed using a 3.0-T magnetic resonance scanner. Main Outcome Measures: Diffusivity changes of the nerve fibres in the visual pathway were calculated through tract-based spatial statistical analysis. The mean diffusivity and fractional anisotropy were assessed and compared with ophthalmological measurements. Results: Compared with controls, bilateral optic tracts and optic radiations in primary open-angle glaucoma patients showed significantly decreased fractional anisotropy and increased mean diffusivity (P < 0.05). In the glaucoma group, the fractional anisotropy of the optic tracts and optic radiations varied consistently with the cup-to-disc ratio, retinal nerve fibre layer thickness and visual function analysis, respectively (P < 0.05). The mean diffusivity of the optic tracts correlated with these ophthalmological measurements (P < 0.05). However, no significant correlation was observed between the mean diffusivity of the optic radiations and the ophthalmological measurements (P > 0.05). Conclusions: The optic tracts and optic radiations of primary open-angle glaucoma patients demonstrated radiological evidence of neurodegeneration. This varied with damage to the optic disc and with the loss of visual function. Tract-based spatial statistical analysis of diffusion tensor imaging is an objective and effective tool for detecting the loss of cortical nerve fibres in primary open-angle glaucoma.