【摘要】 目的：基于动脉自旋标记功能磁共振成像灌注成像技术，系统评估首发精神分裂症患者脑内灌注异常的定位、量化特征及分布规律，明确疾病早期脑血流灌注的改变模式，为首发精神分裂症的病理生理机制探讨、早期影像诊断及临床干预提供客观依据。方法：纳入38例首发精神分裂症患者和38例健康对照者，采集动脉自旋标记灌注成像数据。经标准化预处理后，提取全脑及感兴趣区域的脑血流量（CBF）指标，进行组间比较和相关性分析，以评估脑网络异常连接模式的改变。结果：与健康对照组相比，首发精神分裂症患者在额叶区域表现为CBF显著升高，而在颞叶区域表现为CBF显著降低。结论：首发精神分裂症患者存在以额叶功能过度激活和颞叶功能减退为特征的脑功能失衡模式，且上述异常与临床症状及认知功能密切相关。前额叶与颞叶这两个脑区在疾病早期出现功能协作异常，这很可能是精神分裂症早期发病的核心病理原因。更多还原

【Abstract】 Objective To systematically evaluate the localization, quantitative characteristics, and distribution patterns of abnormal cerebral perfusion in patients with first-episode schizophrenia using arterial spin labeling perfusion MRI, and clarify the alteration patterns of cerebral blood flow perfusion in the early stage of the disease, thereby providing an objective basis for exploring the pathophysiological mechanisms, early imaging diagnosis, and clinical intervention of first-episode schizophrenia. Methods A total of 76 participants were enrolled, including 38 patients with first-episode schizophrenia and38 healthy controls, and their ASL perfusion imaging data were acquired. After standardized preprocessing, cerebral blood flow(CBF) values were extracted from the whole brain and regions of interest. Between-group comparisons and correlation analyses were subsequently conducted to evaluate alterations in abnormal connectivity patterns of brain networks. Results Compared with healthy controls, patients with first-episode schizophrenia showed significantly increased CBF in the frontal lobe and significantly decreased CBF in the temporal lobe. Conclusion Patients with first-episode schizophrenia present a pattern of cerebral functional imbalance characterized by hyperactivation in the frontal lobe and hypoactivation in the temporal lobe, and these abnormalities are closely associated with clinical symptoms and cognitive function. Dysfunctional coordination between the prefrontal and temporal lobes emerges in the early stage of the disease, which may constitute the core pathological mechanism underlying the early onset of schizophrenia.更多还原