正常成人和阿尔茨海默病的扣带回后部质子磁共振频谱研究  

Proton MR spectroscopy study of posterior portion cingulate gyrus both in patients with Alzheimer's disease and normal adults

作　　者：李玉华[1] 张忠阳[1] 殷胜利[1] 

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092

出　　处：《中国医学影像技术》2006年第1期64-66,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的 评价质子磁共振频谱在阿尔茨海默病（AD）诊断中的价值。方法 将研究对象分为三组，即临床拟诊的AD组（18例），血管性痴呆组（VD组，25例），正常对照组（60例）。正常对照组再分为两组（50～60岁组和大于60岁组）。所有病人均排除糖尿病及其他高渗性疾病。对各组进行头颅常规MRI扫描及扣带回后部的单体素PRESS MRS检查，用SPSS软件包进行数据处理，正常对照组间采用团体t检验，正常组与AD组、VD组对比用方差分析法及q检验。结果 正常对照组两年龄段NAA／Cr、Cho／Cr、及mI／Cr值均无显著性差异（P〉0．05）；AD组分别与VD组、正常对照组比较，NAA／Cr、Cho／Cr三组间比较差异无统计学意义（P〉0．05），而mI／Cr值在三组之间比较差异有统计学意义（P〈0．05）。结论 50岁以上正常人群mI／Cr值不会随年龄增长而上升，AD患者扣带回后部mI／Cr值明显升高，若以大于0．76为标准，则本组AD诊断的阳性预测值接近100％，阴性预测值94．5％。Objective To evaluate the role of proton magnetic resonance spectroscopy in patients with Alzheimer＇s disease （AD）. Methods All subjects were divided into three groups： AD group （18 cases）, vascular dementia （VD） group （25 cases）, and normal control group （60 cases）. According to their ages, the control group was classified into two groups： the first group with ages from 50 to 60 years, the second group with ages 〉60 years. We used the same protocols： conventional MRI and MRS. Spectroscopy was acquired by single voxel PRESS, TR 1500 ms, TE 30 ms, volume 8 cm. Saggital view was selected as scout image. The region of interest was located in the posterior portion of cingulate gyrus. We used SPSS software package to process the data. We used grouped t test in testing the difference between the two normal groups and ANOVA for AD, VD and control groups. The ratios of NAA/Cr, Cho/Cr, mI/Cr were analyzed. Results There was no significant differences between the two control goups （P〉0.05）. The ratios of NAA/Cr, Cho/Cr, mI/Cr among AD, VD, and control groups were compared, the results showed no significant differences between the ratios of NAA/Cr, Cho/Cr （P 〉0.05）. However, the ratio of mI/Cr had significant difference （P〈0.05）. Conclusion The ratio of mI/Cr did not in- crease with aging in 〉50 years normal controls. Obvious increasing the ratio of mI/Cr was found in AD group. If the value of mI/Cr measured in the posterior portion cingulated gyrus large than 0.76 was used as criteria of AD, the positive predictive value of AD was 100 %0 and negative predictive value was 94.3 % in this study. But the most important thing was to rule out diabetes and other diseases which also had high mI/Cr.

关 键 词：阿尔茨海默病 痴呆 磁共振波谱学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]