完全性生长激素缺乏患儿大脑皮质脑沟深度与曲率变化的MRI研究

doi:10.3760/cma.j.cn101202-20191225-00385

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摘要目的探讨完全性生长激素缺乏(CGHD)患儿与特发性矮小(ISS)患儿大脑皮质脑沟深度与曲率的差异。方法纳入2015年1月—2019年1月山东大学附属省立医院确诊的CGHD与ISS患儿各12例进行回顾性队列研究。CGHD组男8例、女4例,年龄5~14岁,生长激素刺激释放试验的峰值水平<5.0 μg/L;ISS组男9例、女3例,年龄5~14岁,生长激素的峰值水平>10.0 μg/L。选取患者首诊时所采集的颅脑T₁WI MRI数据进行后处理分析。双侧半球与全脑皮质的脑沟深度与曲率均值应用FreeSurfer软件获得。将同一脑区的脑沟深度与曲率测量值进行组内平均与组间相减,以分别获得每个脑区该测量值的组内均值分布图与组间差异值分布图。两组患儿上述测量均值的组间差异应用协方差分析。结果两组患儿的年龄与性别分布差异均无统计学意义(P值均>0.05)。CGHD组左、右侧半球与全脑的脑沟深度分别为(0.405±0.073)mm、(0.416±0.073) mm、(0.411±0.060)mm;左、右侧半球与全脑的曲率(×10)分别为(0.264±0.023)mm^-1、(0.259±0.017)mm^-1、(0.261±0.019)mm^-1。ISS组左、右侧半球与全脑的脑沟深度分别为(0.493±0.069)mm、(0.502±0.062) mm、(0.497±0.057)mm;左、右侧半球与全脑的曲率(×10)分别为(0.250±0.021)mm^-1、( 0.247±0.025)mm^-1、(0.249±0.022)mm^-1。两组患儿的双侧大脑半球与全脑脑沟深度比较(F_左=9.288、F_右=8.874、F_全=12.545)、左侧半球与全脑曲率比较(F_左=4.688、F_全=5.132),差异均有统计学意义(P值均<0.05)。两组患儿脑沟深度与曲率在全脑的分布规律相似,但存在脑区间测量值大小与分布范围的差异。结论 CGHD患儿与ISS患儿大脑皮质脑沟深度与曲率的MRI测量值存在差异,这可能与其运动、智力或其它相关功能发育相对落后相关。

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	王宇
	许飞飞
	林楠
	杲悦
	林祥涛
	张淑涵
	侯中煜
	于乔文
	王锡明
	刘树伟
	张忠和

关键词 ：人生长激素, 完全性生长激素缺乏, 特发性矮小, 脑沟深度, 曲率, 磁共振成像

Abstract：Objective This study was designed to analyze the morphological differences in cortical sulcal depth and curvature in children with complete growth hormone deficiency (CGHD) and idiopathic short stature (ISS) via the 3.0 T MRI and image postprocessing techniques.Methods This retrospective cohort study included 12 children with CGHD and 12 controls with ISS diagnosed by Shandong Provincial Hospital Affiliated to Shandong University from January 2015 to January 2019. The CGHD group included 8 males and 4 females aged 5-14 years and had peak growth hormone <5.0 μg/L. The ISS group consisted of 9 males and 3 females aged 5-14 years and had peak growth hormone >10.0 μg/L. The three-dimensional T₁-weighted MR images acquired at their first visit were selected for postprocessing analysis. The measurements of the cortical sulcal depth and curvature of the bilateral hemispheres and the total brain were obtained using the FreeSurfer software, and significant differences between groups were statistically analyzed using analysis of covariance. The measurements of cortical sulcal depth and curvature at the same cortical region were averaged within group and subtracted between groups to obtain the mean values and differences, respectively.Results No significant difference in age and gender distribution existed between the two groups (all P values>0.05). The mean cortical sulcal depth of the left and right cerebral hemispheres and the total brain of the CGHD group were (0.405±0.073)mm, (0.416±0.073) mm, (0.411±0.060)mm, respectively. The mean curvature (×10) of the left and right cerebral hemispheres and the total brain of the CGHD group were (0.264±0.023)mm^-1,(0.259±0.017)mm^-1, (0.261±0.019)mm^-1, respectively. The mean cortical sulcal depth of the left and right cerebral hemispheres and the total brain of the ISS group were (0.493±0.069)mm, (0.502±0.062) mm, (0.497±0.057)mm, respectively. The mean curvature (×10) of the left and right cerebral hemispheres and the total brain of the ISS group were (0.250±0.021)mm^-1, (0.247±0.025)mm^-1, (0.249±0.022)mm^-1, respectively. Significant differences in the bilateral hemispheric and total brain cortical sulcal depth (F_left=9.288, F_right=8.874, F_total=12.545) and left hemispheric and total brain curvature (F_left=4.688, F_total=5.132) existed between the CGHD and ISS groups (all P values<0.05). The mean values and differences in the above mentioned measurements were similar in distribution rules across the total brain but were diverse in size and range among cortical regions.Conclusions The CGHD group presented morphological changes in the cortical sulcal depth and curvature compared with the ISS group. This difference may be related to the relatively slower development in motor, intelligence, or other related functions of the CGHD group than those of the ISS group.

Key words： Human growth hormone Complete growth hormone deficiency Idiopathic short stature Sulcal depth Curvature Magnetic resonance imaging

收稿日期: 2019-12-25

基金资助:国家自然科学基金(81300497);山东省博士基金( BS2013YY025)

通讯作者: 张忠和,Email: zhonghezh@163.com

引用本文:

王宇, 许飞飞, 林楠, 杲悦, 林祥涛, 张淑涵, 侯中煜, 于乔文, 王锡明, 刘树伟, 张忠和. 完全性生长激素缺乏患儿大脑皮质脑沟深度与曲率变化的MRI研究[J]. 中华解剖与临床杂志, 2020, 25(4): 337-343.
Wang Yu, Xu Feifei, Lin Nan, Gao Yue, Lin Xiangtao, Zhang Shuhan, Hou Zhongyu, Yu Qiaowen, Wang Ximing, Liu Shuwei, Zhang Zhonghe. Morphological changes in cortical sulcal depth and curvature in children with complete growth hormone deficiency. Chinese Journal of Anatomy and Clinics, 2020, 25(4): 337-343.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20191225-00385 或 http://www.cjac.com.cn/CN/Y2020/V25/I4/337

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