| 王春节,白源,翟方兵,董洋,李静敏.弥散张量成像评估不同类型原发性闭角型青光眼视神经纤维通路变化[J].中国医学影像技术,2021,37(9):1307~1311 |
| 弥散张量成像评估不同类型原发性闭角型青光眼视神经纤维通路变化 |
| Diffusion tensor imaging in evaluating visual nerve fiber pathway changes in different types of primary angle-closure glaucoma |
| 投稿时间：2020-10-04 修订日期：2021-06-14 |
| DOI：10.13929/j.issn.1003-3289.2021.09.006 |
| 中文关键词: 青光眼,闭角型 视神经 磁共振成像 |
| 英文关键词:glaucoma, angle-closure optic nerve magnetic resonance imaging |
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| 中文摘要: |
| 目的 采用弥散张量成像（DTI）观察原发性闭角型青光眼（PACG）视神经纤维通路变化，分析其与临床分期的相关性。方法 对25例慢性原发性闭角型青光眼（CPACG，A组，50眼）、17例急性闭角型青光眼（APACG，B组，34眼）患者及8名健康对照者（C组，16眼）采集眼部DTI；PACG临床分期0期7眼、1期33眼、2期9眼、3期12眼、4期16眼、5期7眼。比较3组间视神经及视放射区各向异性（FA）和平均弥散率（MD）的差异，以及0期青光眼与C组DTI参数的差异，分析CPACG及APACG的DTI参数与青光眼临床分期的相关性。结果 与C组比较，A、B组视神经及视放射区FA降低、MD升高（P均<0.05），A、B组间DTI参数差异无统计学意义（P均>0.05）。CPACG视神经、视放射区FA与临床分期呈负相关（r=-0.286、-0.284，P均<0.05）；APACG组DTI参数与临床分期无明显相关（P均>0.05）。0期青光眼视神经及视放射区FA较C组降低（P均<0.01）。结论 DTI有助于早期诊断青光眼；急、慢性PACG均存在不同程度视神经纤维通路损伤，CPACG视神经、视放射区FA与临床分期呈负相关，而APACG急性发作期的DTI参数与临床分期无明显相关。 |
| 英文摘要: |
| Objective To observe the changes of optic nerve fiber pathway in patients with primary angle-closure glaucoma (PACG) with diffusion tensor imaging (DTI), and to explore the correlations with clinical staging of PACG. Methods Totally 25 patients with chronic primary angle-closure glaucoma (CPACG) (group A, 50 eyes), 17 with acute angle-closure glaucoma (APACG) (group B, 34 eyes) and 8 age-matched healthy controls (group C, 16 eyes) underwent ocular DTI. The clinical stages of glaucoma were 7 eyes of stage 0, 33 eyes of stage 1, 9 eyes of stage 2, 12 eyes of stage 3, 16 eyes of stage 4 and 7 eyes of stage 5. The fractional anisotropy (FA), mean diffusivity (MD) of optic nerve and optic radiation area were measured and compared among 3 groups. DTI parameters were compared between stage 0 glaucoma and control group, and the correlations of DTI parameters of CPACG or APACG and clinical stages of glaucoma were analyzed. Results Compared with group C, the optic nerves and optic radiations of group A and B had lower FA and higher MD (all P<0.05). There was no significant difference of DTI parameters between group A and B (all P>0.05). FA of optic nerve and optic radiation area in CPACG were negatively correlated with clinical stages (r=-0.286, -0.284, both P<0.05). There was no correlation of DTI parameters and clinical stages of APACG (both P>0.05). FA of optic nerve and optic radiation area in 0 stage glaucoma were lower than those of group C (both P<0.01). Conclusion DTI was helpful for early diagnosis of glaucoma. In both CPACG and APACG patients, optic nerve fiber pathways were damaged in various degrees. FA of optic nerve and optic radiation region in CPACG were negatively correlated with clinical stages, while DTI parameters of APACG in acute phase had no correlation with clinical stages. |
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