摘要目的 研究扩散张量成像(DTI)参数各向异性分数(FA)值和平均扩散系数(DCavg)值对脑实质型囊虫病的分期诊断价值.方法 搜集大理大学第一附属医院2015年1月至2016年12月经临床确诊的48例脑实质型囊虫病,男30例,女18例;年龄19~65岁,平均(34±11)岁.其中亚临床期8例,水样囊泡期13例,胶样囊泡期15例,肉芽肿结节期12例.所有患者均行DTI扫描,测量各时期病灶FA值和DCavg值,以及病灶镜像对照正常脑实质的FA值和DCavg值,各分期病灶的FA值和DCavg值的比较采用方差分析,病灶及其对应侧镜像FA值和DCavg值的比较采用配对t检验.结果 脑实质型囊虫病亚临床期、水样囊泡期、胶样囊泡期及肉芽肿结节期对应的FA值分别为0.0747±0.0025、0.1058±0.0031、0.1273±0.0021、0.1593±0.0014,各时期间差异具有统计学意义(F=639.17,P<0.05),两两比较差异也有统计学意义.各时期DCavg值分别为(1.3125±0.0067)×10-3、(1.5142±0.0059)×10-3、(1.1121±0.0058)×10-3、(1.0932±0.0084)×10-3mm2/s,差异具有统计学意义(F=491.24,P<0.05),两两比较差异也有统计学意义.各时期病灶FA值和DCavg值与其对应镜像正常脑实质间差异均有统计学意义(P<0.05).结论 DTI参数FA值及DCavg值有助于脑实质型囊虫病分期诊断,为临床治疗提供指导作用.

abstractsObjective To study the staging of cerebral parenchymal cysticercosis by fractional anisotropy(FA) value and average diffusion coefficient(DCavg) value on diffusion tensor imaging(DTI). Methods Forty-eight patients (30 men and 18 wemen) with cerebral parenchymal cysticercosis were admitted to the First Affiliated Hospital of Dali University from January in 2015 to December in 2016.Their averge age was(34±11)years(rang from 19 to 65 years).Eight patients with subclinical stage, 13 patients with vesicular stage, 15 patients with colloidal-vesicular stage,and 12 patients with granular-nodular stage of cerebral neurocysticercosis were included in this study. The data of FA and DCavg of lesions with different stages were measured, as well as the contralateral normal brain parenchyma. The FA values and DCavg values of lesions were analyzed by variance analysis,respectively.Paired t test was used to compare the FA and DCavg values of the lesions and the contralateral brain.Results The FA values of lesions with subclinical stage, vesicular stage, colloidal-vesicular stage, and granular-nodular stage of cerebral parenchymal cysticercosis were 0.074 7±0.002 5,0.105 8±0.003 1,0.127 3±0.002 1,and 0.159 3±0.001 4, respectively.The differences were statistically significant among the stages(F=639.17,P<0.05).The DCavg values were(1.312 5±0.006 7)×10-3,(1.514 2±0.005 9)×10-3,(1.112 1±0.005 8)×10-3,and(1.093 2±0.008 4)× 10-3mm2/s for lesions with each stage, respectively. There was a significant difference in the DCavg values among the stages(P<0.05).The data of FA and DCavg for lesions with every stage had a significant difference from those of normal contralateral brain(F=491.24, P<0.05). Conclusion The parameters FA and DCavg values of diffusion tensor imaging may be helpful in the diagnosis of different stages of cerebral parenchymal cysticercosis,and may provide guidance for clinical treatment.