MAGiC序列在HIV相关神经认知障碍诊断中的应用价值

doi:10.19871/j.cnki.xfcrbzz.2022.03.012

摘要/Abstract

摘要： 目的应用MAGiC技术定量测量HIV感染者颅内T1值、T2值、PD值,探索MAGiC序列在HIV相关神经认知障碍诊断中的应用价值。方法回顾性分析2021年5–9月在深圳市第三人民医院行磁共振MAGiC技术检查HIV感染者38例。根据是否出现HIV相关神经认知障碍（HAND）分为两组（非HAND组23例,HAND组15例）,另选18例无HIV感染者为正常对照组。应用MAGiC技术定量测量大脑左右侧半卵圆中心、侧脑室前后角、左右侧基底节区、胼胝体膝部、脑干和小脑的T1弛豫时间（ms）、T2弛豫时间（ms）和质子密度PD（pu）值。采用独立样本Kruskal-Wallis检验进行两两组间对比,并绘制ROC曲线。结果 ①HAND组各测量点的T1值均高于非HAND组和正常对照组,差异有统计学意义（P<0.05）;②非HAND组和正常对照组各测量点T1值、T2值、PD值差异均无统计学意义（P>0.05）;③T1值对区分HAND、非HAND的效能最好,以右侧基底节T1值曲线下面积0.897最大,其敏感度为1,特异度为0.725,P<0.001,最佳诊断阈值998.33ms。结论 HAND患者颅内各部位T1值明显高于非HAND患者和无HIV感染者,通过定量测量T1值可以反映HIV感染者是否出现神经认知障碍,可以作为一种判断HAND新的辅助检查技术。

关键词: 人类免疫缺陷病毒, 认知功能障碍, 磁共振, 定量成像技术

Abstract: Objective To quantitatively measure intracranial T1 value, T2 value and PD value of AIDS patients with MAGiC technology, and to explore the application value of MAGiC sequence in the diagnosis of HIV-related neurocognitive disorders. Method From May 2021 to September 2021, 38 hiv-infected patients were examined by magnetic resonance MAGiC technology in Shenzhen Third People's Hospital were retrospectively analyzed. According to the presence of HIV-associated neurocognitive disorder (HAND), the patients were divided into two groups (23 cases in the non-HAND group and 15 cases in the HAND group), and 18 cases without HIV infection were selected as the normal control group. T1-mapping (MS), T2-mapping (MS) and proton density PD(PU) values of both centrum semiovale, anterior horn of lateral ventricle, posterior horn of lateral ventricle, both basal ganglia, genu of corpus callosum, brainstem and ce-rebellum were quantitatively measured by MAGiC technique.The independent samples Kruskal-Wallis test was used for comparison between two groups, and the ROC curve was drawn. Result ①The T1 value of each measuring point in the HAND group was higher than that in the non-HAND group and the normal control group, and the difference was statistically significant (P<0.05); ②There were no significant differences in T1,T2 and PD values between the non-HAND group and the normal control group (P>0.05); ③T1 is the most effective for distinguishing HAND from non-hand. The area under the curve of T1 value in the right basal ganglia was 0.897, the sensitivity was 1, the specificity was 0.725, P<0.001, and the optimal diagnostic threshold was 998.33ms. Conclusion The T1 value of each intracranial part of HAND patients is significantly higher than that of non-HAND patients and non-HIV-infected patients. Quantitative measurement of T1 value can reflect whether HIV-infected patients.

Key words: Human immunodeficiency virus, Cognitive dysfunction, Magnetic resonance, Quantitative imaging techniques

罗杰棋, 周昀, 巢华, 云永兴, 王展, 鲍晓慧, 郭昂, 郑广平. MAGiC序列在HIV相关神经认知障碍诊断中的应用价值[J]. 新发传染病电子杂志, 2022, 7(3): 55-59.

Luo Jieqi, Zhou Yun, Chao Hua, Yun Yongxing, Wang Zhan, Bao Xiaohui, Guo Ang, Zheng Guangping. Application value of MAGiC sequences in the diagnosis of HIV-related neurocognitive disorders[J]. Electronic Journal of Emerging Infectious Diseases, 2022, 7(3): 55-59.

参考文献

[1] WORLD HEALTH ORGANIZATION.HIV/AIDS[EB/OL].[2021-10-30].https://www.Who.int/news-room/fact-sheets/detail/hiv-aids.
[2] 张倩倩, 陆普选. HIV相关神经认知疾病的功能磁共振成像研究进展[J/CD]. 新发传染病电子杂志, 2016, 1(1):56-59.
[3] 中华医学会感染病学分会艾滋病丙型肝炎学组,中国疾病预防控制中心. 中国艾滋病诊疗指南(2018版)[J/CD]. 新发传染病电子杂志, 2019, 4(2):65-84.
[4] ANTINORI A, ARENDT G, BECKER JT, et al.Updated research nosology for HIV-associated neurocognitive disorders[J]. Neurology, 2007, 69(18):1789-1799.
[5] ANCES BM, HAMMOUD DA.Neuroimaging of HIV-associated neurocognitive disorders (HAND)[J]. Current Opinion in Hiv & Aids, 2014, 9(6):545-551.
[6] DUCHAUSSOY T, BUDZIK JF, NORBERCIAK L, et al.Synthetic T2 mapping is correlated with time from stroke onset: a future tool in wake-up stroke management[J]. Eur Radiol, 2019, 29(12): 7019-7026.
[7] TANENBAUM LN, TSIOURIS AJ, JOHNSON AN, et al.Synthetic MRI for clinical neuroimaging: results of the magnetic resonance image compilation (MAGi C) prospective, multicenter, multireader trial[J]. AJNR Am J Neuroradiol, 2017, 38(6): 1103-1110.
[8] 李瑞利, 李宏军. HIV相关神经认知功能障碍综合征的MRI神经影像学研究进展[J]. 磁共振成像, 2019, 10(06):456-460.
[9] 邓文娟, 赵婷婷, 金观桥, 等. DTI对HIV感染者HAART疗效评估的价值研究[J/CD]. 新发传染病电子杂志, 2017, 2(1):14-17,34.
[10] 袁虹. 艾滋病合并脑内寄生虫感染的临床及影像表现[J/CD]. 新发传染病电子杂志, 2018, 3(4):239-243.
[11] 李瑞利, 米海峰, 李宏军, 等. 常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析[J].首都医科大学学报, 2016, 37(4):454-459.
[12] 马景旭, 杨豫新, 刘莹, 等. 磁共振DTI成像技术在艾滋病合并脑内结核和弓形虫感染中的应用价值[J/CD]. 新发传染病电子杂志, 2019, 4(1):15-19.
[13] 吴文浩, 俞文君, 朱诞恬, 等. 集成磁共振成像技术对正常成年人海马的定量测量评估[J]. 磁共振成像, 2021, 12(5):55-59.
[14] 刘辉明, 尹国平, 别非, 等. 对比集合序列与常规序列头部MR图像质量[J]. 中国医学影像技术, 2019, 35(2):268-271.
[15] 王佳男, 朱婧怡, 张博, 等. 脑良恶性胶质瘤实质与瘤周T1、T2值差别的研究[J]. 磁共振成像, 2020,11(6):416-421.
[16] LORIO S, TIEMEY TM, DOWELL MCA, et al.Flexible proton density (PD)mapping using multi-contrast variable flip angle (VFA)data[J].Neuroimage, 2019, 186: 464-475.
[17] 孙鹏, 王巍, 刘鹏飞. 正常成人海马磁共振定量测量研究[J]. 哈尔滨医科大学学报, 2012, 46(3):281-284,314.