【作者】 王颖；

【导师】 黄力；

【作者基本信息】 暨南大学 ， 医学影像与核医学， 2007， 硕士

【摘要】 研究目的：利用DTI和MRS研究未经药物治疗的首发精神分裂症阳性型患者脑功能，探讨其病因学机制。材料和方法：对26例患者和20例正常人行脑部常规MRI和DTI检查，两组均为右利手。选取胼胝体膝部、压部，双侧额叶白质，扣带束前部，海马头为ROI区测量FA值。其中12例患者行双侧额叶和海马2D~1H-MRS检查。对数据进行统计分析。结果：1．患者组、对照组常规MRI检查无阳性发现。2．对照组左侧扣带束FA值大于右侧；患者组测量部位左右两侧相应ROI区FA值无差异。3．患者组胼胝体压部、左右扣带束前部FA值低于对照组。4．DTT纤维跟踪示：患者组胼胝体、扣带束纤维走行正常，在纤维跟踪图上不能比较其与对照组差异。5．患者组左侧额叶白质Cho／Cr小于右侧；双侧额叶灰质各代谢物比值无差异；额叶白、灰质间各代谢物比值无差异。海马头NAA／Cr和Cho／Cr左侧小于右侧。结论：1．患者扣带束左大于右扩散异性偏侧化缺失、胼胝体压部白质纤维束受损。2．患者额叶仅存在白质膜代谢异常而无神经元功能损害和白质纤维束完整性和方向性丧失，这可能为阳性型的特征表现。3．患者可能在脑发育阶段已存在脑内连接异常，和左侧大脑半球，尤其是左侧边缘系统功能障碍，支持神经发育假说观点。4．DTI和MRS可显示脑功能改变，联合运用在精神分裂症病因学研究中具有实用价值。更多还原

【Abstract】 Objective: To perform the MRI, diffusion tensor imaging and proton MR spectroscopic imaging in first-episode and neuroleptic-naive patients with positive symptoms of schizophrenia and to have a better understanding of advanced MR technology in schizophrenia.Methods: DTI was performed on 26 patients with positive symptoms of schizophrenia and 20 normal comparison subjects, and their fractional anisotropy values were subsequently measured in multiple brain regions. To measure FA values in genu and splenium of corpus callosum, frontal white matter, anterior cingulum, hippocampus respectively. And 12 patients were selected to perform MRS examination. Statistical analysis was performed.Results: 1. The statistical results showed a remarkable left-greater-than-right asymmetry anisotropy in the anterior cingulum bundles in normal peoples. 2. Reduced FA was seen for splenium of corpus callosum in the schizophrenia patients than was seen in the comparison subjects. 3. Reduced FA was seen for both sides of the anterior cingulum in the schizophrenia patients, who showed a lack of normal left-greater-than-right asymmetry in the anterior cingulum than was seen in the comparison subjects. 4. The Cho/Cr in left frontal white matter was lower than that in fight of schizophrenic patients. 5. Brain metabolite levels did not differ between left anterior cingulate gray matter and right. 6. Brain metabolite levels did not differ between frontal white matter and gray matter. 7. The NAA/Cr, Cho/Cr in left hippocampus was lower than that in right of patients. Conclusion: 1. The patients with positive symptoms of schizophrenia showed a lack of normal left-greater-than-right asymmetry seen in the comparison subjects.2. There date, while preliminary, suggest that impaired left cerebral hemisphere may be associated with positive symptoms of schizophrenia, which supports the brain dysfunction in schizophrenia. 3. Abnormalities in throughput of phospholipid membrane in frontal white matter maybe peculiarity of positive symptoms of schizophrenia. 4. The advanced MR technology was very useful in schizophrenia.更多还原