中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2019, Vol. 48 ›› Issue (7): 582-586.doi: 10.12007/j.issn.0258-4646.2019.07.002

• 论著 • 上一篇    下一篇

功能磁共振检测甲状腺癌根治术后老年患者脑皮质结构的改变

马铃1, 娄宁2, 代玉婷1   

  1. 1. 中国医科大学附属盛京医院麻醉科, 沈阳 110004;
    2. 沧州中心医院麻醉科, 河北 沧州 061014
  • 收稿日期:2019-02-26 出版日期:2019-07-30 发布日期:2019-07-17
  • 通讯作者: 马铃 E-mail:maling27@hotmail.com
  • 作者简介:马铃(1975-),女,副教授,博士.
  • 基金资助:
    国家自然科学基金(81302534)

Changes in Cortical Voxel-Based Morphometry Findings Detected by Functional MRI in Elderly Patients after Radical Thyroidectomy

MA Ling1, LOU Ning2, DAI Yuting1   

  1. 1. Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 100004, China;
    2. Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou 061014, China
  • Received:2019-02-26 Online:2019-07-30 Published:2019-07-17

摘要: 目的 通过功能磁共振(fMRI)利用基于体素的形态测量学研究行甲状腺癌根治术的老年患者手术前后脑皮质结构的变化,探讨全身麻醉和手术对老年患者脑皮质结构的近期影响。方法 选取择期在全身麻醉下行甲状腺癌根治术的30例年龄≥65岁、ASA分级Ⅱ~Ⅲ级的患者为研究对象,符合纳入标准的患者共20例。患者分别于手术当天早晨及术后3 d接受颅脑核磁扫描,由专业测试人员进行简易智力状态检查量表(MMSE)评估并记录手术前后得分。分析手术前后MMSE得分及脑皮质结构的变化。结果 手术前后MMSE评分无统计学差异。颅脑核磁影像结果显示,术后左右侧海马体及后扣带回处灰质密度明显降低。结论 全身麻醉下行甲状腺癌根治术可降低老年患者海马体和后扣带回皮质密度。

关键词: 功能磁共振, 基于体素的形态测量学, 海马体, 后扣带回

Abstract: Objective To explore the postoperative changes in cortical voxel-based morphometry findings detected by functional magnetic resonance imaging(fMRI)in elderly patients after radical thyroidectomy. Methods We included a total of 20 elderly patients(age ≥ 65 years,ASA Ⅱ-Ⅲ)who underwent radical surgery for thyroid cancer removal under general anesthesia. Brain fMRI was performed on the morning of the surgery and 3 days post-surgery. Mental assessment was performed by professional testers using the mini-mental state examination(MMSE)scale 1 day before and 3 days after surgery. Preoperative and postoperative MMSE scores and cerebral cortical structure were analyzed statistically. Results There was no significant difference between the pre- and postoperative MMSE scores. However, the voxel-based morphometric analysis of the fMRI revealed a significant postoperative reduction in gray matter density in the hippocampus and posterior cingulate gyrus. Conclusion Radical thyroidectomy performed under general anesthesia in elderly patients can cause a reduction in gray matter density in the hippocampus and posterior cingulate gyrus,as detected using functional MRI.

Key words: functional MRI, voxel-based morphometry, hippocampus, posterior cingulate cortex

中图分类号: 

  • R614.2
[1] NAKAZONO T,LAM TN,PATEL AY,et al. Impaired in vivo gamma oscillations in the medial entorhinal cortex of knock-in Alzheimer model[J]. Front Syst Neurosci,2017,30(11):48. DOI:10.3389/fnsys.2017.00048.
[2] VANNINI P,HANSEEUW B,MUNRO CE,et al. Anosognosia for memory deficits in mild cognitive impairment:insight into the neural mechanism using functional and molecular imaging[J]. Neuroimage Clin,2017,25(15):408-414. DOI:10.1016/j.nicl.2017.05.020.
[3] ARNAIZ E,JELIC V,ALMKVIST O,et al. Impaired cerebral glucose metabolism and cognitive functioning predict deterioration in mild cognitive impairment[J]. Neuroreport,2001,12(4):851-855.
[4] NESTOR PJ,FRYER TD,SMIELEWSKI P,et al. Limbic hypometabolism in Alzheimer's disease and mild cognitive impairment[J]. Ann Neurol,2003,54(3):343-351. DOI:10.1002/ana.10669.
[5] PERROTIN A,DESGRANGES B,LANDEAU B,et al. Anosognosia in Alzheimer disease:disconnection between memory and self-related brain networks[J]. Ann Neurol,2015,78(3):477-486. DOI:10.1002/ana.24462.
[6] MINOSHIMA S,GIORDANI B,BERENT S,et al. Metabolic reduction in the posterior cingulate cortex in very early Alzheimer's disease[J]. Ann Neurol,1997,42(1):85-94. DOI:10.1002/ana.410420114.
[7] BOZZALI M,FILIPPI M,MAGNANI G,et al. The contribution of voxel-based morphometry in staging patients with mild cognitive impairment[J]. Neurology,2006,67(3):453-460. DOI:10.1212/01. wnl.0000228243.56665.c2.
[8] MILLER MI,YOUNES L,RATNANATHER JT,et al. The diffeomorphometry of temporal lobe structures in preclinical Alzheimer's disease[J]. Neuroimage Clin,2013,16(3):352-360. DOI:10.1016/j.nicl.2013.09.001.
[9] WHITWELL JL,PRZYBELSKI SA,WEIGAND SD,et al. 3D maps from multiple MRI illustrate changing atrophy patterns as subjects progress from mild cognitive impairment to Alzheimer's disease[J]. Brain,2007,130(Pt 7):1777-1786. DOI:10.1093/brain/awm112.
[10] KULASON K,NOUCHI R,HOSHIKAWA Y,et al. Indication of cognitive change and associated risk factor after thoracic surgery in the elderly:a pilot study[J]. Front Aging Neurosci,2017,5(9):396. DOI:10.3389/fnagi.2017.00396.
[11] KRENK L,RASMUSSEN LS,KEHLET H. New insights into the pathophysiology of postoperative cognitive dysfunction[J]. Acta Anaesthesiol Scand,2010,54(8):951-956. DOI:10.1111/j.1399-6576.2010.02268.x.
[12] SHAEFI S,MARCANTONIO ER,MUELLER A,et al. Intraoperative oxygen concentration and neurocognition after cardiac surgery:study protocol for a randomized controlled trial[J]. Trials,2017,18(1):600. DOI:10.1186/s13063-017-2337-1.
[13] KADOI Y,KAWAUCHI C,IDE M,et al. Preoperative depression is a risk factor for postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus[J]. J Anesth,2011,25(1):10-17. DOI:10.1007/s00540-010-1072-5.
[14] FEINKOHL I,WINTERER G,PISCHON T. Diabetes is associated with risk of postoperative cognitive dysfunction:a meta-analysis[J]. Diabetes Metab Res Rev,2017,33(5):e2884. DOI:10.1002/dmrr.2884.
[15] MONK TG,WELDON BC,GARVAN CW,et al. Predictors of cognitive dysfunction after major noncardiac surgery[J]. Anesthesiology, 2008,108(1):18-30. DOI:10.1097/01.anes.0000296071.19434.1e.
[16] NEWMAN MF,KIRCHNER JL,PHILLIPS-BUTE B,et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery[J]. N Engl J Med,2001,344(6):395-402. DOI:10.1056/NEJM200102083440601.
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