磁共振扩散张量成像在抑郁症疗效观察中的初步研究.pdfVIP

南方医科大学学报(J South Med Univ) ·1905· 磁共振扩散张量成像在抑郁症疗效观察中的初步研究 夏 军 ，雷 益 ，徐化剑 ，冯 伟 ，伍晓六 ，刘小林 ( 深圳市第二人民医院放射科，广东 深圳 518035；z武汉 市精神病医院，湖北 武汉 430022) 摘要：目的探讨扩散张量成像(DTI)在抑郁症疗效观察中的价值。方法 l8例抑郁症患者和 l3例健康对照组行常规 MRI和DTI扫描，DTI确定选定层面额叶白质的各向异性值(FA)，对抑郁症患者给予选择性5．羟色胺抑制剂氟西汀 治疗8周。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体评定量表(CGI)评定临床疗效。结 果氟西汀的治疗总有效率为67％，显效率为56％，无效率为33％，治疗无效患者额叶白质纤维束FA值较低．与治疗有 效者和健康对照组相比差异有显著性。结论DTI能显示抑郁症患者额叶白质纤维束细微结构的异常，这种异常提示其 治疗疗效欠佳。 关键词：抑郁症；氟西汀；弥散张量成像 中图分类号：R749．42 文献标识码：A 文章编号：1673-4254(2007)12．1905．03 Preliminary study of diffusion tensor imaging in treatment response assessment of major depression XIA Jun ，LEI Yi ，XU Hua-jian ，FENG Wei ，wu Xiao-liu ，LIU Xiao-lin2 Department ofRadiology，Second People’S Hospital of Shenzhen，Shenzhen 5 1 8035，China；Vqguhan Psychiatry Hospital，Wuhan 430022， China Abstract：0bjective To assess the value of diffusion tensor imaging(DTI) in therapeutic effect evaluation of major depression． Methods Eighteen patients who met the CCMD-3-R criteria for major depression or bipolar disorder(with depressed episode and total score 11o less than 18 for l7 items ofHamilton Depression Rating Scale、 and l3 aged-matched controls were examined by routine magnetic resonance imaging (MR 1 and DTI． DT1 were used to determine fractional anisotropy(FA) in the preselected white matter regions． All the patients with major depression received treatment with selective serotonine reuptake inhibitor(ssm)for 6．8 weeks，and the efficacy were assessed by Hamilton Depression Scale， Hamilton Anxiety Scale(HhMA)，and Clinical Global Impression(CGI)scale．Results The t0tal response rate to fluoxetine was 67％．and signiticant improvement was observed in 56％of the patients while 33％failed to respond after 8 weeks of treatment．Thedepressed subjectsfailingto respondtothetreatmenthad a signiticantlowerFAofthefrontal