阿尔茨海默病的脑磁共振成像三维测量研究  

Measurement of brain structural changes in patients with Alzheimer disease using 3－ dimentional magnetic resonance images

作　　者：肖世富[1] 昂秋青[1] 姚培芬[1] 刘福根[1] 何慧瑾[2] 黄红芳[1] 张选红[1] 沈天真[2] 江开达[1] 张明园[1] 

机构地区：[1]上海市精神卫生中心,上海200030 [2]复旦大学附属华山医院,上海200040

出　　处：《中国组织工程研究与临床康复》2001年第17期42-43,共2页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：卫生部科研基金( 98- 1- 320);上海市卫生系统百人计划科研基金( 98BR033)资助

摘　　要：目的用 MRI三维测量法研究阿尔茨海默病 (Alzheimer Disease,AD)患者的脑形态结构变化特点。方法 AD组和认知功能正常的老年人 (对照组， NC组 )，脑三维测量使用 MRI组织分割和体积测量分析技术。结果 AD组 23例，简明智力状态检查（ MMSE）的平均总分为 (18.9± 4.7)分，韦氏记忆测验的记忆商（ MQ）为 (44.2± 14.4)分； NC组 29例， MMSE平均总分和 MQ分别为 (28.4± 1.7)分和 (96.5± 10.0)分。 MRI三维测量结果显示，两组间脑灰质体积、左右海马体积、所有脑室体积、脑室外脑脊液和总脑脊液体积分别有显著或极显著性差异。 AD组的灰质体积平均比 NC缩小了 12.6％，左右海马体积分别缩小了 23.8％和 22.7％。大脑结构的改变与认知功能显著相关。多元逐步判别分析显示脑灰质百分比具有显著性判别意义，两组判别总正确率为 76.9％。结论脑 MRI三维测量能定量化了解 AD的脑部形态结构的改变，作为 AD诊断和评价病情进展的辅助指标。Objective To Assess brain structural changes in patients with Alzheimer disease using 3－ dimentional magnetic resonance images. Method Subjects were divided into two groups, the patients with Alzheimer disease (AD) and normal controls (NC). A computerized volumetry and tissue－ segmentation program was used to quantify volumes of hippocampal formation (HF), gray matter (GM), white matter (WM), ventricular and Cerebrospinal fluid (CSF). Result 23 mild to moderate patients with AD and 29 NC were recruited. The mean total scores of the mini－ mental status examination (MMSE) were 18.9± 4.7 for AD group and 28.4± 1.7 for NC group and the mean total scores of the memory quotients (MQ) were 44.2± 14.4 for AD and 96.5± 10.0 for NC. Compared with the control subjects, the patients with AD showed significantly decreased total GM volume , HF volume , and GM fraction , and increased ventricular and CSF fraction.The GM, left HF and right HF volume decreased by 12.6％， 23.8％ and 22.7％ respectively. These structural changes significantly correlated to cognitive function changes. A linear discriminant function was obtained with stepwise discriminant analysis and variables of GM fraction entered the function with a discriminative accuracy of 76.9％ . Conclusion 3－ dimentional magnetic resonance image technique can accurately quantify the brain structural changes of Alzheimer disease. Decreased GM and HF volumes and increased ventricular volumes can be used as a diagnostic, even early detection mark, and are helpful in assessing the progress of the disease.

关 键 词：阿尔茨海默病 核磁共振三维测量 简明智力状态检查 

分 类 号：R749.1[医药卫生—神经病学与精神病学]