Prediction Of Patients With Herpes Zoster Transformation Based On Diffusion Tensor Imaging

Objective:Use tract-based spatial statistics(TBSS)based on white matter fiber bundles to explore the changes in the microstructure of white matter in patients with herpes zoeter(HZ),and use diffusion tensor imaging(DTI)parameter values Correlation analysis with clinical indicators can predict the outcome of HZ patients from the perspective of imaging and provide help for exploring more effective treatment methods.Methods:A 3.0T magnetic resonance scanner was used to perform diffusion tensor imaging scans on 41 HZ patients and 20 age-and gender-matched healthy control groups(Health control group,HC group).According to the follow-up of the HZ patients after the scan,the HZ The patients were divided into groups A and B.Group A was HZ patients whose follow-up results did not progress to postherpetic neuralgia(PHN),and Group B was HZ patients whose follow-up results progressed to PHN.The scanned image Use FSL(FMRIB’s Software Library)software for processing,use TBSS technology to analyze and compare the diffusion index parameters of group A,group B and healthy control group,and analyze the difference between the brain area diffusion index parameter value and the patient’s visual analog scale(Visual analog scale,VAS),course of disease,STAI scale,BDI scale for correlation analysis.Results:(1)Compared with HC group,the brain areas with increased AD value in group A were left anterior thalamic radiation,corpus callosum(splenium,genu),bilateral inferior fronto-occipital fasciculus,bilateral superior fronto-occipital fasciculus,bilateral superior longitudinal fasciculus,left uncinate fasciculus,bilateral corona radiata,left external capsule,bilateral posterior limb of internal capsule,and left retrolenticular part of the internal capsule;the brain areas with increased MD value were corpus callosum,right inferior fronto-occipital fasciculus,bilateral inferior longitudinal fasciculus,bilateral superior longitudinal fasciculus,right posterior limb of the internal capsule and retrolenticular part of the internal capsule,bilateral corona radiata,right posterior thalamic radiation,right external capsule;brain areas with increased RD value:left inferior fronto-occipital fasciculus,left inferior longitudinal fasciculus,left superior longitudinal fasciculus,splenium of the corpus callosum,left posterior limb of the internal capsule,left retrolenticular part of the internal capsule,left corona radiata,left lateral capsule.(P<0.05,FWE corrected)There was no significant difference in FA value between group A and healthy control group.(2)Compared with HC group,the areas with lower FA value in group B were fmajor forceps major,bilateral inferior fronto-occipital fasciculus,bilateral inferior and superior longitudinal fasciculus,corpus callosum,left posterior limb of the internal capsule and retrolenticular part of the internal capsule,bilateral corona radiata,right posterior thalamic radiation and stria terminalis,bilateral external capsule;the areas with higher AD value were bilateral anterior thalamic radiation,left corticospinal tract,fmajor forceps major,bilateral fmajor forceps major,left inferior longitudinal fasciculus,bilateral superior longitudinal fasciculus,left uncinate fasciculus,corpus callosum,bilateral posterior limb of the internal capsule,right retrolenticular part of the internal capsule,bilateral corona radiata,left posterior thalamic radiation,bilateral external capsule;The brain areas with increased MD value were bilateral anterior thalamic radiation,fmajor forceps major,bilateral inferior fronto-occipital fasciculus,bilateral inferior and superior longitudinal fasciculus,corpus callosum,bilateral corona radiata,bilateral external capsule;The brain areas with increased RD value were bilateral anterior thalamic radiation,fmajor forceps major,bilateral inferior fronto-occipital fasciculus,bilateral inferior and superior longitudinal fasciculus,corpus callosum,bilateral corona radiata,bilateral external capsule(P<0.05,FWE corrected.(3)Compared with group A,the brain area with significantly lower FA value in group B was the splenium of corpus callosum;the left anterior thalamic radiation,AD,MD and RD values of corpus callosum(splenium and corpus callosum)in group B were increased(P<0.05,FWE corrected).(4)There was a negative correlation between FA and course of disease in group B(HZ patients with PHN progression)and group A(HZ patients without PHN progression).There was a positive correlation between MD and AD and course of disease(P<0.05,RFA=-0.638,RMD=0.668,RAD=0.673).Conclusions:(1)Compared with the healthy control group,HZ patients had a wide range of abnormal changes in the microstructure of white matter,including sensory,emotional,cognitive,memory,motor and so on.The area of white matter microstructure changes in HZ patients with PHN was more extensive.(2)Compared with the patients without PHN,the areas with abnormal diffusion indexes in the patients with PHN include the anterior thalamic radiation and corpus callosum.These changes are positively correlated with the course of the disease,suggesting that these brain areas may be involved in the progress of HZ-PHN and may be used as markers to predict the outcome of HZ.(3)Correlation analysis of brain DTI parameter values and disease course between HZ patients with PHN progression and HZ patients without PHN progression showed that the changes of brain white matter microstructure in the early stage of HZ patients had nothing to do with the disease course,and prolonged disease course in HZ patients resulted in increased risk of PHN progression.