臺灣博碩士論文加值系統

一氧化碳中毒(Carbon monoxide intoxication, COI)是一種常見的意外疾病，通常伴隨著全身的缺氧症狀。此類病患腦部神經變化有幾種，包含神經系統的後遺症、神經行為的改變以及認知上的障礙。病患急性一氧化碳中毒以後，部分發展成慢性一氧化碳中毒，另一部分則是因為機率效應而出現延遲症狀。目前已經有證據顯示一氧化碳中毒的病患會出現白質髓鞘脫失，使得皮質區域之間連結的缺失，造成認知神經網絡功能整合上的障礙。
擴散張量造影(Diffusion Tension Image, DTI)是目前已知的一種對白質神經纖維具有高敏感度的非侵入性造影，對於白質病變之病灶偵測的臨床診斷相當有助益。本研究進行神經纖維重建並使用FSL內建神經機率圖譜。將利用神經機率圖譜建構完成的11條白質神經纖維使白質損傷具體量化，而量化後的參數將用以評估白質的損傷程度。

Carbon monoxide (CO) intoxication is an unexpected condition. Patients have several symptoms include neurological sequelae, neurobehavioral changes, and cognitive impairments. After acute CO intoxication, part of patients may develop progressive chronic CO intoxication and the others appear delayed syndrome by probability effect. Evidence suggests that the white matter (WM) demyelination caused by CO intoxication may lead to functional disintegration of neurocognitive networks due to disconnection between cortex areas.
Diffusion tensor imaging (DTI) is a noninvasive method to intercepted information about the anatomy of WM pathways and provides advantage for clinical diagnosis. In this study, we used pre-created WM parcellation atlas-based probabilistic maps of 11 major WM tracts in FSL to quantify and evaluate WM tract damages in patients with CO intoxication.

ACKNOWLEDGEMENTS I
CHINESE ABSTRACT II
ABSTRACT III
CONTENTS IV
LIST OF FIGURES VI
LIST OF TABLES VIII
CHAPTER1 INTRODUCTION 1
1.1 Carbon Monoxide Intoxication 1
1.1.1 Clinical Characterization 1
1.1.2 Acute, Chronic and Delay Stages 2
1.1.3 Demyelination 4
1.2 Diffusion Magnetic Resonance Imaging 6
1.2.1 Diffusion Principle 6
1.2.2 Diffusion Tensor Imaging 9
1.3 Tractography 13
CHAPTER2 MATERIAL &; METHODS 16
2.1 Participants 16
2.2 Image Acquisition 17
2.3 Tract Probabilistic Map 18
2.4 Image Processing 21
2.5 Statistical Analysis 23
CHAPTER3 RESULTS 25
3.1 Diffusion Tensor Imaging Indices 25
3.1.1 Cross-sectional comparison 25
3.1.2 Cerebral change with delayed syndrome 43
3.2 Longitudinal Influence in Delayed Syndrome 49
3.3 Correlations between MMSE and cognitive performances 56
3.3.1 Mini-Mental Status Examination, MMSE 56
3.3.2 Cognitive Behavior Defect in COI Patients 57
CHAPTER4 DISCUSSIONS 60
4.1 Diversification in COI 60
4.1.1 Nerve Damage 60
4.1.2 Correlation with Cognitive Behavior and Tract Probabilistic Map 61
4.2 Time-dependent in Delayed Syndrome 63
4.3 Limitations of the study 64
4.3.1 Participants concerns 64
4.3.2 Statistic issues 65
4.3.3 Methodological issues 67
4.4 Future Works 68
CHAPTER5 CONCLUSION 69
CHAPTER6 REFERENCE 70
APPENDIX A

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