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研究生:李孟勳
研究生(外文):Meng-hsun Lee
論文名稱:運用高解析度T1權重影像與磁化率權重影像觀察一氧化碳中毒的大腦結構變化:九個月之追蹤研究
論文名稱(外文):Cerebral structural change of carbon monoxide intoxication by usinghigh-resolution T1WI and SWI: a 9-month follow-up study
指導教授:莊子肇
指導教授(外文):Tzu-Chao Chuang
學位類別:碩士
校院名稱:國立中山大學
系所名稱:電機工程學系研究所
學門:工程學門
學類:電資工程學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
論文頁數:56
中文關鍵詞:一氧化碳中毒磁化率權重影像遲發性腦神經精神症候群白質萎縮蒼白球
外文關鍵詞:globus pallidussusceptibility weighted imagingdelayed neuropsychiatric syndromecarbon monoxide poisoningwhite matter atrophy
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一氧化碳中毒對於大腦會造成缺氧性的損傷,在有些案例的磁共振影像上可以發現到大腦組織有萎縮的現象,也有些案例於白質或深層灰質,如:蒼白球(globus pallidus),可以觀察到亮度的異常。本研究藉由FreeSurfer軟體使用voxel-based morphometry的演算法來量測多個大腦組織的體積,比較一氧化碳中毒後一個月與九個月不同組織的體積變化,並且使用paired t-test評估兩個時間點的差異性,另外由於蒼白球富含鐵離子,也利用磁化率權重影像對於鐵離子的累積有高度敏感這個特性,觀察蒼白球在不同時間追蹤影像中的改變。
研究結果發現在白質區域九個月的體積相較於一個月的體積有顯著性的減少(P=0.016),將有沒有發生遲發性腦神經精神症候群(delayed neuropsychiatric syndrome, DNS)的患者分開,可以發現發生DNS患者白質體積有極顯著性的減少(P=0.001),沒有發生DNS的患者則無明顯改變,另外在磁化率權重影像上,在有些案例中可以於蒼白球上觀察到有區域性高信號(regional hyperintensity)與點狀低訊號(dotted hypointensity)的出現,區域性高信號出現時會伴隨著點狀低訊號,但與DNS的發生沒有關聯性。
Carbon monoxide poisoning may cause brain hypoxic injury. According to previous magnetic resonance imaging report, brain atrophy could happen on surviving patients. In addition, abnormal signal intensity is possible in white matter and deep gray matter, such as globus pallidus. In this longitudinal study, voxel-based morphometry is performed by using FreeSurfer to investigate the volumetric change of brain tissues. Data collected at one and nine months after carbon monoxide poisoning, respectively, are compared by using the paired t-test. In addition, susceptibility weighted imaging, which is sensitive for the accumulation of paramagnetic substances, is also applied to monitor the appearance of the ion-rich global pallidus at several follow-up experiments.

Compared to one-month follow-up, white matter volume is found to decrease significantly at nine month (P=0.016). The decrease of white matter volume is more apparent on those patients with delayed neuropsychiatric syndrome (P=0.001). On the contrary, no significant difference is found on patients without DNS. In susceptibility weighted imaging, regional hyperintensity and dotted hypointensity can be observed on globus pallidus in some cases. However, according to the limited sample size of this study, regional hyperintensity will be accompanied by dotted hypointensity appears, but both of them are not related to the occurrence of DNS.
論文審定書 i
致謝 ii
摘要 iii
Abstract iv
圖目錄 vii
表目錄 ix
第一章 介紹 1
1.1 背景 1
1.2 文獻探討 6
1.2.1 灰、白質體積變化 6
1.2.2 SWI特性 9
1.3 研究動機 10
第二章 影像資料與方法 11
2.1 受試者影像資料收集 11
2.2 體積變化處理方法 13
2.2.1 FreeSurfer處理原理與流程 13
2.2.2 體積比較方法與統計 16
2.3 SWI處理方法 17
2.3.1 處理流程 17
2.3.2 Phase unwrapping 18
2.3.3 高通濾波器 20
2.3.4 SWI組成 21
第三章 結果 22
3.1 體積變化結果 22
3.1.1 影像分割結果 22
3.1.2 體積變化結果 23
3.2 SWI結果 29
3.2.1 不同的半高全寬 29
3.1.2 不同時間追蹤之SWI 31
第四章 討論與結論 36
4.1 灰、白質體積討論 36
4.2 SWI特徵討論 41
4.3 結論 43
References 44
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