高齡病患腦部組織退化與肌少症之間的相關性:擴散峰度造影及體素型態分析之研究

The correlations between brain tissue alterations and sarcopenia in elderly patients: A diffusion kurtosis imaging and voxel-based morphometry study

陳勁為(Chin-Wei Chen)

指導教授 ： 周銘鐘

高雄醫學大學/健康科學院/醫學影像暨放射科學系碩士班/碩士(2019年)

摘要

目的：本研究主要以體素形態分析(Voxel-Based Morphometry, VBM)以及擴散峰度造影(Diffusion Kurtosis Imaging, DKI)研究認知功能與肌少症量表與大腦灰白質間的相關性。

材料與方法：我們使用了60位病患的T1及DKI資料，並且收集病患的認知功能量表(MMSE)、最大握力、行走速率與肌肉密度等，配合新加入的方法CAT12與無閾值團簇增強法(Threshold Free Cluster Enhancement,TFCE)來進行T1及DKI的影像分析，並且與傳統SPM分析結果進行比較，來探討灰白質與MMSE、最大握力及行走速率等量表間的相關性。

結果與討論：在CAT12與傳統SPM12的比較中可以發現CAT12在 MMSE與灰質有較好的相關性且有更貼近理論的表現，使CAT12可能具有優於SPM12的潛力。而使用CAT12探討灰質的VBM，可以發現肌少症量表中的最大握力量表與MMSE被發現表現出與灰質訊號的變化有明顯的相關性，而此種現象在傳統SPM12是看不到的。然而在白質研究中，使用TFCE尋找不同DKI參數影像與臨床量表的相關性也確實有找出許多顯著正/負相關的區域，但礙於資料與方法學上的受限無法找出較好的解釋。

結論：本篇研究使用CAT12用以改良SPM12的VBM分析，就結果上來說有些表現CAT12都是優於SPM12的。另外在握力量表也被發現到具有檢測皮質衰減的潛力。希望這部分的結果能在未來相關領域的研究中能夠作為一份資料供其他研究參考。

關鍵字

VBM ； CAT12 ； DKI ； 老化 ； 肌少症 ； TFCE

並列摘要

Purpose: This study try to figure out the correlations between brain tissue alterations and sarcopenia in aging people by using Voxel-Based Morphometry (VBM) and Diffusion Kurtosis Imaging (DKI).

Materials and Methods: In this study, we enrolled 60 aging subjects and acquired high-resolution T1 and DKI data from each participant on a 3T MRI scanner. In addition, Mini-Mental State Examination (MMSE), maximum hand grip strength (MHGS), and gait speed were obtained from each patient. The imaging data were statistically analyzed using CAT12 and Threshold Free Cluster Enhancement (TFCE) and the results were compared with conventional SPM to understand the relationship between gray, white matter, MMSE, MHGS, and gait speed..

Results and Discussion: The comparison between CAT12 and SPM12 methods showed that CAT12 had better correlation coefficients between gray matter and MMSE. Also, CAT12 found more area with significantly positive correlation in MMSE and MHGS scales. However, this phenomenon in MHGS was not detected by conventional SPM12 method. This study also used TFCE to investigate the correlation between white matter, MMSE, MHGS, and gait speed. Although we found several areas with significant correlation, we still are not able to conclude the findings behind these phenomena due to lack of ground truth.

Conclusion: The results of this study indicated new findings which could be useful in similar research. Firstly, CAT12 shows better performance than SPM12 in several conditions when conducting gray matter segmentation. Secondly, VBM analysis using CAT12 demonstrates that MHGS has higher relationship with gray matter than MMSE, and MHGS might be a potential scale to detect gray matter atrophy.

並列關鍵字

VBM ； CAT12 ； DKI ； aging ； sarcopenia ； TFCE

參考文獻

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