The Value Of Diffusion Kurtorsis Imaging In Evaluating Microstructure Change Of The Brain In Patients With Hypertension

Objective: To investigate the value of DKI in evaluating microstructure change of the brain in patients with hypertension in order to detect useful imaging diagnostic indicators to evaluate early changes of brain microstructure change of the brain in hypertension patients.Materials and Methods: 39 cases with hypertension were collected, 17 cases of them who did not have any drugs to control the blood pressure before were divided into No Treatment Group(NTG) and the other 22 cases that had antihypertensive therapy for a long time were divided into Treatment Group(TG). Then 18 normal persons were matched as Normal Control Group(NCG). All subjects were performed regular MRI examination firstly in order to exclude those who had organic disease in the brain, and then MR-DKI were performed. After scanning, the images of DKI were transmitted to image post-processing workstation, software called functool were used to deal with the images and got the data. The value of MK, MD, AK, RK in bilateral caudate nucleus, bilateral putamen, bilateral thalamus, bilateral internal capsule hind legs, bilateral frontal white matter, bilateral white matter around the lateral ventricle hind angle, bilateral locus ruber,corpus callosum knee and the ministry of corpus callosum were measured. The value of the left and right sides were recorded separately. The sum of same indicators of bilateral symmetry parts(with the exception of corpus knee and the ministry of corpus callosum) divided by 2 was the average of the left and right sides(ALR) of the corresponding parts; the sum of same indicators of corpus knee and the ministry of corpus callosum divided by 2 was the average of the corpus callosum(ACC); The sum of same indicators of ALR of bilateral caudate nucleus, bilateral putamen, bilateral thalamus and bilateral locus ruber divided by 4 was the corresponding indicator value of normal appearing grey matter of each subject(NAGM). As the same, the sum of same indicators of ALR of bilateral internal capsule hind legs, bilateral frontal white matter, bilateral white matter around the lateral ventricle hind angle and the corresponding indicator value of ACC divided by 4 was the corresponding indicator value of normal appearing white matter of each subject(NAWM). Use SPSS13.0 software to test and analyze the data.Results:(1)When comparing left and right sides of brain in NCG, there were significant differences between the MK value in bilateral caudate nucleus, bilateral thalamus and bilateral frontal white matter, the MD value in bilateral internal capsule hind legs and bilateral frontal white matter, the AK value in bilateral caudate nucleus and bilateral frontal white matter as well as the RK value in bilateral thalamus and bilateral frontal white matter. While comparing left and right sides of brain in TG and NTG, several DKI parameters appeared difference. Most MK、AK and RK values were higher in the left side than in the right side in each group, while this rule did not apply to MD value.(2)When comparing ipsilateral cerebral white matter among groups,there was more difference between NCG and NTG as well as NCG and TG; When comparing ipsilateral cerebral grey matter among groups,there was more difference between NCG and TG as well as NTG and TG.(3)When comparing the average of each place,there was more difference in AK and RK value. When comparing the average of NAWM in each group, we found that most of them were RK value the highest, followed by MK value, MD value and AK value, while comparing the average of NAGM in each group, most of them were MD value the highest, followed by AK value, MK value, and RK value. When comparing NAWM among the three groups, we found that there was big difference in RK value, RK value of TG was the highest,followed by NTG and NCG;when comparing NAGM among the three groups, there was big difference in AK value, AK value of TG was the highest,followed by NTG and NCG.Conclusion: DKI technology can find the difference of the left and right sides of brain in normal adult. The brain of hypertension patients whose head perform negative in regular MRI scanning has a certain degree damage of microstructure, maybe DKI technology can early detect these changes and does something for revealing the etiology, pathogenesis and predicting the progress of this disease. RK value may be a sensitive index to detect change of white matter and AK with MK may be a sensitive index to detect change of grey matter. Antihypertensive drugs significantly cause the microstructure of brain change.