Optic nerve diffusion tensor imaging parameters and their correlation with optic disc topography and disease severity in adult glaucoma patients and controls.
Optic nerve diffusion tensor imaging parameters and their correlation with optic disc topography and disease severity in adult glaucoma patients and controls.
复制标题
成人青光眼患者和对照组中视神经扩散量张量参数及其与视盘形态和疾病严重程度的相关性。
DOI：
10.1097/ijg.0b013e318294861d
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发表时间：
2014-10
影响因子：
2
通讯作者：
Barnett EM
中科院分区：
文献类型：
--
作者：
Chang ST;Xu J;Trinkaus K;Pekmezci M;Arthur SN;Song SK;Barnett EM
目的：评价青光眼患者和对照组的视神经弥散张量成像（DTI）参数，并将DTI参数与Heidelberg视网膜断层扫描（HRT）获得的边缘面积和青光眼分期系统（glaucoma分期系统）的青光眼损害程度相关联。设计:初步研究。方法：27例青光眼患者和12例对照组分别行DTI和HRT成像。主要预后指标包括：分数各向异性、平均扩散系数、轴向扩散系数、径向扩散系数、HRT边缘面积和青光眼分期系统分期。结果：组间比较，青光眼患者的平均扩散系数（1.33 vs. 0.91 μ 2/ms， P= 0.0002）、轴向扩散系数（1.70 vs. 1.43 μ 2/ms， P= 0.036）、径向扩散系数（1.24 vs. 0.71 μ 2/ms， P< 0.0001）显著高于对照组，分数各向异性（0.21 vs. 0.44， P< 0.0001）显著低于对照组。青光眼患者的平均扩散率、轴向扩散率和径向扩散率随角膜边缘面积的减小和青光眼分期的增加而增加，分数各向异性降低（P< 0.05）。但相邻对分期比较DTI参数差异无统计学意义（P < 0.05）。结论：DTI可能是一种有效的检测和评估视神经青光眼损伤的技术，特别是对于无法进行常规影像学和视野检查的患者。未来的研究需要评估DTI参数如何随青光眼损伤在视觉通路内的纵向变化，并在扩散张量量化中解决脑脊液部分体积效应，特别是对于青光眼晚期患者。
Purpose:To evaluate optic nerve diffusion tensor imaging (DTI) parameters in glaucoma patients and controls, and to correlate DTI parameters with the rim area obtained with Heidelberg retina tomography (HRT) and with the severity of glaucomatous damage using the Glaucoma Staging System.Design:Pilot study.Methods:Twenty-seven patients with glaucoma and 12 control subjects underwent DTI and HRT imaging. Main outcome measures included: fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity, HRT rim area, and Glaucoma Staging System stage.Results:In group comparison, mean diffusivity (1.33 vs. 0.91 μm 2/ms, P= 0.0002), axial diffusivity (1.70 vs. 1.43 μm 2/ms, P= 0.036), and radial diffusivity (1.24 vs. 0.71 μm 2/ms, P< 0.0001) were significantly higher and fractional anisotropy (0.21 vs. 0.44, P< 0.0001) was significantly lower in the glaucoma compared with those of control subjects. In glaucoma patients, mean, axial, and radial diffusivities increased and fractional anisotropy decreased as rim area decreases and the Glaucoma stage increased (P< 0.05). However, there were no statistically significant differences in the DTI parameters when adjacent pairs of stages were compared (P> 0.05).Conclusions:DTI may be a useful technique for detection and evaluation of glaucomatous damage in the optic nerve, particularly for patients in whom conventional imaging and perimetry are not possible. Future studies are needed to evaluate how DTI parameters change longitudinally with glaucomatous damage within the visual pathways and address cerebrospinal fluid partial volume effects in diffusion tensor quantification, especially for patients with advanced glaucoma stage.