中文摘要：

目的：探讨基于体素内不相干运动扩散加权成像（IVIM-DWI）研究围产期HIV感染无症状型青少年脑扩散与灌注信息可行性及其变化特征。方法：收集临床确诊围产期HIV感染无症状青少年18例（HIV~＋组）和来自艾滋病家庭年龄、性别匹配HIV阴性对照组（HIV-组）17例。受试者均行常规MR脑平扫和IVIM-DWI检查。IVIM-DWI选取7个b值,经MITK软件拟合和MRICroN软件测量获得双侧尾状核和额叶白质IVIM参数值的平均值（D值、D＊值和f值）。独立样本t检验、Pearson相关性分析IVIM参数值与CD4~＋T淋巴细胞计数、CD4/CD8比值的相关性。结果：与对照组比较,HIV~＋组尾状核和额叶白质灌注扩散系数D＊值有显著降低（P〈0.01）;D＊值与CD4~＋T淋巴细胞计数、CD4/CD8比值呈显著正相关（尾状核r分别为0.719和0.640;额叶白质r分别为0.440和0.546;P〈0.05）。HIV~＋组尾状核和额叶白质D值和f值差异无统计学意义,与CD4~＋T淋巴细胞计数、CD4/CD8比值无显著相关性。结论：IVIM-DWI能敏感检测围产期HIV感染无症状型青少年尾状核和额叶白质微循环灌注不相干运动D＊值的变化,D＊值可能作为HIV感染脑部变化早期和进展评估的可视化标志物。

英文摘要：

Objective：To explore the Intravoxel Incoherent Motion diffusion-weighted imaging（IVIMDWI）feasibility and change in the brain of adolescent with perinatal HIV infection.Methods：We collected eighteen children with perinatally HIV infection（HIV~＋group）and seventeen HIV negative children matched aged and gender as control group.All subjects were examined on the brain by a 3.0T MR scanner using conventional cerebral sequences and IVIM-DWI（Seven b values）.IVIM parameter values（D,D＊and f value）could be got by fitting MITK software and measuring MRICroN software,while mean values were from bilateral caudate nucleus and frontal white matter.Correlation of independent sample t-test and Pearson correlation analysis between D,D＊,f values and CD4~＋T lymphocytes counts and CD4/CD8 Tlymphocytes were analyzed.Results：Compared with HIV-group,D＊values of caudate nucleus and frontal white matter in HIV~＋group significantly decreased（P0.01）;D＊values with CD4~＋count and CD4/CD8 were significantly positively correlated（r of caudate nuclear：0.719 and 0.640;r of frontal white：0.440and0.546;P0.05）.D and f values of caudate nucleus and frontal white matter showed no statistically difference,there was no significant correlation between D and f values to CD4~＋count and CD4/CD8.Conclusion：IVIM-DWI can sensitively detect cerebral D＊changes related microcirculation incoherent motion in caudate nucleus and frontal white matter of perinatal HIV infection asymptomatic adolescents,and D＊value is a potential visual biomarker in estimating the HIV~＋cerebral early change and progress.