MRI及DTI直方图分析对皮质下血管性认知功能障碍的评价作用  

Evaluation of conventional MR and whole brain diffusion tensor imaging histogram in vascular cognitive impairment

作　　者：周滟[1] 林富春[2] 朱炯[1] 李焰生[3] 钱黎俊[1] 陶静[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127 [2]中国科学院武汉物理与数学研究所,波谱与原子分子物理国家重点实验室,湖北武汉430071 [3]上海交通大学医学院附属仁济医院神内科,上海200127

出　　处：《医学影像学杂志》2008年第6期577-581,共5页Journal of Medical Imaging

基　　金：上海市自然基金06ZR14122项目资助

摘　　要：目的:利用常规MRI和扩散张量成像(DTI)直方图分析,明确血管性认知损害(VCI)患者的脑部病变严重程度评分、DTI直方图指标与简易智能量表(MMSE)间的关系。方法:对19例VCI患者、24例中风后无认知功能障碍患者(Stroke组)行常规MRI和DTI检查,各组之间性别、年龄和受教育程度相匹配。计算T2WI可见病变体积、脑白质内高信号病灶的评分(General WMH评分),而全脑各向异性分数(FA)和平均扩散率(MD)图像分析。结果:VCI患者的FA和ADC直方图与Stroke组不同,VCI患者平均全脑平均FA值降低,FA峰高增高。VCI组平均General WMH评分、平均FA值、FA峰高和FA峰位置与MMSE评分相关。结论:VCI患者皮质下白质病变的严重程度与认知功能损害程度有关,全脑DTI直方图分析较常规MRI具有更好的客观性和可重复性,某些指标可用于评价疾病的严重程度。Objective： Studies were carried out to detect brain tissue damage in patients with vascular cognitive impairment （VCI） using conventional magnetic resonance imaging （MRI） and diffusion tensor imaging （DTI） histogram analysis. We also detemfined the correlations between the severity of white matter lesions, DTI histogram derived measures and mini-mental state examination （MMSE） scores.Methods：Conventional MR/and DTI scans were performed in 19 patients with VCI and 24 age-and sex-matched post-stroke patients without cognitive impairment （stroke group）. The volume of T2WI visible lesions, general WMH rating scale, whole brain apparent diffusion coefficient （ADC） and fractional anisotropy （FA） histograms were evaluated. Results：Analysis showed that the patterns of the whole brain ADC and FA histograms of the VCI group differed from those of the stroke group. The mean FA value was significantly lower and the FA histogram peak height was higher in the VCI group. There were a correlation between the general WMH rating scale, the average FA, the FA histogram peak height and the FA histogram peak location in patients with VCI and MMSE scores. Conclusion： Our findings suggest the severity of subcortical white matter lesions in VCI may be related to cognitive function. Whole brain DTI histogram is more objective and repeatable, and some of the DTI histogram derived measures might be useful in monitoring the severity of cognitive impairment in this disease.

关 键 词：血管性认知功能障碍 扩散张量成像 直方图分析 表观弥散系数 各项异性指数 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]