基于3D磁共振动脉自旋标记成像研究早餐进食对大脑血流灌注改变的影响

目的初步研究早餐进食对大脑血流灌注（CBF）改变的影响。方法选取30例健康志愿者，所有志愿者均行饭前空腹3D磁共振动脉自旋标记成像检查以及饭后(39.6±12.66)min行第二次动脉自旋标记检查，对早餐进食前后的CBF图配准到Montreal Neurological Institute（MNI）空间，基于Anatomical Automatic Labeling（AAL）分区模板提取全脑灰质及各个脑区的CBF值，并进行配对t检验和Bland-Altman分析，基于皮尔森相关分析CBF改变与临床指标的潜在联系。结果相比空腹CBF，早餐进食后，21个脑区(左侧眶部额中回、左侧三角部额下回、左侧中央沟盖、右侧中央沟盖、左侧脑岛、右侧脑岛、左侧前扣带和旁扣带脑回、左内侧和旁扣带脑回、右内侧和旁扣带脑回、右侧楔叶、左侧枕上回、右侧枕上回、左侧枕中回、右侧枕中回、左侧枕下回、右侧枕下回、左侧顶上回、左侧缘上回、右侧颞横回、左侧颞上回、右侧颞上回)的CBF显著降低。这些CBF改变与临床变量［早餐进食后ASL间隔时间、年龄、性别、体质指数（BMI）、收缩压、舒张血压和平均血压］等因素无显著相关。结论早餐进食降低CBF，该改变与年龄、性别、BMI指数以及血压等因素无关，提示临床评估血流灌注应考虑进食影响。

Objective To investigate the effects of breakfast intake on cerebral blood flow（CBF）. Methods Thirty healthy volunteers were selected, all volunteers performed meal fasting 3D MRI arterial spin marker imaging and a second arterial spin marker examination in the range of(39.6±12.66) minutes after breakfast. CBF perfusion map before and after breakfast were registered to Montreal Neurological Institute(MNI) space. The CBF values of the whole-brain gray matter and each brain region were extracted based on the Anatomical Automatic Labeling(AAL) partitioning template. Paired T-tests and Bland-Altman analysis were also performed. Potential association of CBF changes and clinical indicators were analyzed based on Pearson correlation analysis. Results Compared with fasting CBF perfusion, the CBF perfusion of 21 brain regions after breakfast intake(including left orbital middle frontal gyrus, left triangular inferior frontal gyrus, left central sulcus cover, right central sulcus cover, left insula, right insula, left anterior cingulate and paracingulate gyrus, left medial and paracingulate gyrus, right medial and paracingulate gyrus, right wedge lobe, left superior occipital gyrus, right superior occipital gyrus, left middle occipital gyrus, right middle occipital gyrus, left inferior occipital gyrus, right inferior occipital gyrus, left superior parietal gyrus, left superior marginal gyrus, right transverse temporal gyrus, left superior temporal gyrus and right superior temporal gyrus) decreased significantly. These CBF changes were not significantly correlated with clinical variables ［age, ASL interval after eating, body mass index(BMI), blood pressure and mean blood pressure］. Conclusion Breakfast intake decreases the CBF perfusion, which is not related to age, gender, BMI index and blood pressure, indicating that the diet should be considered in clinical perfusion evlaution.