阿尔茨海默病患者脑结构影像变化与认知功能的相关性研究  

Brain structure image measured by 3-dimensional-magnetic resonance imagin correlates with cognitive function in patients with Alzheimer's disease

作　　者：王涛[1] 肖世富[1] 李霞[1] 郝晶[2] 陈克敏[2] 

机构地区：[1]上海交通大学医学院附属上海市精神卫生中心老年科,上海200030 [2]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《内科理论与实践》2007年第5期328-331,共4页Journal of Internal Medicine Concepts & Practice

基　　金：上海市百人计划项目资助(项目编号:98BR033)

摘　　要：目的:研究轻、中度阿尔茨海默病人脑结构影像变化与简易智力状态检查量表(MMSE)及阿尔茨海默病评定量表认知分量表(ADAS-cog)评分的相关性。方法:按美国精神障碍诊断和统计手册第4版(DSM-Ⅳ)阿尔茨海默病诊断标准入组23例患者,进行MMSE及ADAS-cog评分。并应用三维磁共振显像(3D-MRI)测量海马结构、杏仁体、内嗅皮质、旁嗅皮质、颞角、钩间距等指标。三维扰相梯度回波序列(3D-SPGR)-T1加权成像后,在GE后处理工作站上对3D-MRI资料进行后处理、统计及标准化。将标准化结果与患者的认知功能评分结果进行相关分析。结果:右侧旁嗅皮质体积(r=0.540,P=0.014)、旁嗅皮质总体积(r=0.473,P=0.035)与MMSE评分呈显著正相关;而钩间距长度与MMSE评分呈显著负相关(r=-0.461,P=0.041);其余结构未发现与MMSE评分的相关性。右侧旁嗅皮质体积(r=-0.628,P=0.002)、左侧旁嗅皮质体积(r=-0.522,P=0.018)和旁嗅皮质总体积(r=-0.644,P=0.003)与ADAS-cog评分呈显著负相关;而钩间距长度与ADAS-cog评分呈显著正相关(r=0.558,P=0.011);其余结构未发现与ADAS-cog评分的相关性。结论:旁嗅皮质、钩间距长度在阿尔茨海默病患者的诊断中具有重要意义,与MMSE及ADAS-cog检查相结合可有助于阿尔茨海默病的诊断及对病情进展的评价。Objective To investigate the relationship between magnetic resonance imaging（MRI）-based measurement of brain structure and mini-mental state examination （MMSE）, as well as Alzheimer＇s disease （AD） assessment scalecognitive subscale （ADAS-cog） in patients with mild to moderate AD. Methods A total of 23 AD patients underwent 3- dimensional MRI （3D-MRI） with T1-weighted imaging, including volumetric measurements of hippocampus, amygdala, entorhinal cortex （EC）, perirhinal cortex （PC）, cornu temporale and linear measurement of uncus distance. 3D-spoiled gradient echo （SPGR）-T1 weighted images were also acquired with the GE 1.5T EXCITE HD MR Imaging System and the 8NVHEAD_A COIL. The scanning parameters were TE/TR 1.6/7.7, field of view 24.0 cm×24.0 cm, slice thickness 0.5 mm, slice pace 0.7 mm, slad 230 mm, matrix size 256×256, and NEX 1.00. Results There was significant relationship between right PC volume and MMSE score （r=-0.540,P=0.014）, between total PC volume and MMSE score （r=0.473,P= 0.035）, uncus distance and MMSE score （r=-0.461 ,P=0.041）. The following parameters demonstrated close relationship with ADAS-cog score： right PC volume （r=-0.628,P=0.002）, left PC volume （r=-0.522,P=0.018）, total PC volume （r=-0.644, P=0.003）, as well as uncus distance （r=0.558,P=0.011）. There was no significant relationship between other brain structures and MMSE, ADAS-cog score. Conclusions PC and uncus distance atrophy were fairly sensitive imaging markers of AD patients. Combination of MMSE and ADAS-cog might help to evaluate the status and progression of AD.

关 键 词：阿尔茨海默病 三维磁共振显像 认知功能 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]