摘要目的:探讨慢性脑桥梗死（pontine infarction, PI）患者灰质体积（gray matter volume, GMV）改变及结构协变网络（structural covariant network, SCN）模式的异常。方法:前瞻性纳入2014年10月至2021年6月郑州大学第一附属医院和天津医科大学总医院收治的首发单侧慢性期PI患者作为病例组，同时纳入年龄、性别及受教育年限相匹配的健康受试者作为正常对照组。收集受试者高分辨率三维T 1结构MRI图像及行为学评分。采用基于体素的形态学分析和双样本 t检验探索组间GMV的差异。以GMV差异脑区作为种子点，构建SCN探索PI患者结构协变模式的异常。采用Spearman秩相关分析差异脑区GMV与行为学评分的相关性。 结果:共纳入60例PI患者，其中左侧PI 33例，右侧PI 27例，同时纳入34例健康对照者。与正常对照组比较，左侧PI组双侧小脑后叶GMV显著缩小，右侧PI组左侧小脑前后叶及右侧小脑后叶GMV均显著缩小（高斯随机场校正，体素水平 P<0.001，簇水平 P< 0.05，簇体素>20），且左侧小脑前后叶及右侧小脑后叶GMV值与患者运动功能评分存在显著相关性（ P<0.05）。此外，与正常对照组相比，右侧PI组存在更广泛的协变脑区且协变脑区间结构连接数量显著增多（簇类错误校正， P<0.05，簇体素>20）。 结论:慢性PI患者双侧小脑后叶GMV显著缩小，且继发更广泛的协变脑区及结构连接。这可能是PI患者行为功能受损的神经机制。

abstractsObjective:To investigate the changes in gray matter volume (GMV) and abnormalities in structural covariant network (SCN) patterns in patients with chronic pontine infarction (PI).Methods:Patients with unilateral chronic PI (case group) with the first onset admitted to the First Affiliated Hospital of Zhengzhou University and Tianjin Medical University General Hospital from October 2014 to June 2021 were prospectively included. At the same time, healthy subjects matched with age, gender and education years (normal control group) were included. High-resolution three-dimensional T 1 structural MRI images and behavioral scores of the subjects were collected. The voxel-based morphometry and two-sample t test were used to explore the differences in GMV between the groups. Using GMV differential brain regions as seed points, SCN was constructed to explore the abnormality of structural covariant patterns in patients with PI. Spearman rank correlation analysis was used to analyze the correlation between GMV in differential brain regions and behavioral scores. Results:A total of 60 patients with PI were enrolled, including 33 left PI and 27 right PI, while 34 healthy controls were also enrolled. Compared with the normal control group, the GMV in bilateral posterior cerebellar lobe decreased significantly in the left PI group, and the GMV in left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe decreased significantly in the right PI group (Gaussian random field correction with voxel level P<0.001 and cluster level P<0.05, cluster voxel >20), and there was a significant correlation between GMV values in the left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe and the motor function score ( P<0.05). In addition, compared with the normal control group, the right PI group had broader covariate brain regions and a significant increase in the number of structural connections between covariate brain regions (family-wise error correction with voxel level P<0.05, cluster voxel >20). Conclusions:The GMV in bilateral posterior cerebellar lobe decreases significantly in patients with chronic PI, and were secondary to broader covariate brain regions and structural connections. This may be the neural mechanism of impaired behavioral function in patients with PI.