目的 应用基于体素磁共振形 态测量(Voxel based morhometry， VBM)研究腰椎间盘突出(Lumbar disc herniation，LDH)患者慢性期疼痛使脑结 构发生改变的区域。方法 搜集新乡医学 院第二附属医院已确诊为腰间盘突出且疼 痛持续时间超过3个月患者58名为病例组 (LDH组)，62名健康志愿者为正常对照组 (HC组)，利用西门子3.0T核磁共振对120 名受试者进行3DT1结构成像，然后使用 SPM-VBM软件对采集的磁共振数据进行分 析，最后采用REST软件包进行统计学分 析。结果 与HC组相比，LDH患者在右侧扣 带回、左额叶、左颞上回、左顶下小叶等 区域的白质(WM)体积存在差异(FDR校正， P＜0.05)；在右小脑前叶、右中央前回、 右小脑后叶、左梭状回、左额上回、右尾 状核、右额中回、左颞中回、右扣带回等 区域的灰质(GM)体积存在差异性(FDR校 正，P＜0.05)。结论 利用VBM软件能够发 现LDH慢性期疼痛患者脑灰质和白质存在 差异的区域，可以为临床治疗和预后提供 有效的价值。

Objective To study the changes of brain structure in patients with chronic lumbar disc herniation (LDH) by using Voxel based morhometry (VBM). Methods 58patients were diagnosed as lumbar disc herniation with a duration of more than 3 months(LDH). 46 healthy volunteers were the normal control group (HC) The 3D magnetic resonance imaging was performed on 104 subjects. The magnetic resonance data were analyzed by spm-VBM software. Finally, REST and AFN software was used for statistical analysis. Results Compared with HC group, the volume of white matter (WM) in LDH patients was significantly different in the right cingulate gyrus, left frontal lobe, left superior temporal gyrus, Left inferior parietal lobule(P＜0.05). In the right anterior lobe of cerebellum, right precentral gyrus, right posterior lobe of cerebellum, left fusiform gyrus, left superior frontal gyrus, right caudate nucleus, right middle frontal gyrus, left middle temporal gyrus, right cingulate areas of gray matter (GM) volume differences(P ＜0.05). Conclusion Can be found in chronic phase LDH patients with pain of brain gray and white matter differences between regions by using the VBM software, can provide effective value for clinical treatment and prognosis.