Alzheimer病患者扣带回后部损害磁共振扩散张量成像的研究  

Study of diffusion tensor imaging of posterior cingulate gyrus damage in patients with Alzheimer's disease

作　　者：段金海[1] 汪华侨[2] 陈少琼[3] 徐杰[2] 林贤[2] 康庄[3] 姚志彬[2] 

机构地区：[1]广东省人民医院东病区神经内科,广东省老年医学研究所,广州510080 [2]中山大学基础医学院解剖学教研室脑研究室 [3]中山大学附属第三医院MR室

出　　处：《临床神经病学杂志》2009年第1期1-3,共3页Journal of Clinical Neurology

基　　金：国家自然科学基金(30400512);广东省自然科学基金(7300973;7001284;20013137);广东省社会发展项目(2005B10401047);广州市科技计划项目(2004Z3-E0151)

摘　　要：目的探讨Alzheimer病(AD)患者扣带回后部磁共振扩散张量成像(DTI)的特点及其与认知功能改变的相关性。方法对16例AD患者和12名健康老人(正常对照组)行DTI、T1Flair及T2Flari检查,测量扣带回后部各向异性分数值(FA)、平均弥散度(MD)及其λ1、λ2及λ33个特征值,分析上述诸项数值与简易精神状态检查量表(MMSE)评分之间的相关性。结果与正常对照组相比,AD组患者扣带回后部的FA值显著降低(P<0.05),而MD、λ1、λ2及λ3值明显升高(均P<0.05);FA值与MMSE评分不相关(r=-0.054,P>0.05),而MD值与MMSE评分呈显著负相关(r=-0.664,P<0.01);λ1、λ2及λ3值均与MMSE评分呈负相关(r=-0.643,r=-0.69,r=-0.654,均P<0.01)。结论AD患者表现为扣带回后部各向异性损害,且损害程度与临床认知功能评分呈负相关;这种损害反映了AD病理机制中皮质-皮质及皮质-皮质下联系的丢失;DTI可以用来监测AD疾病的进展及评价药物的临床疗效。Objective To investigate the features of diffusion tensor imaging （DTI） of posterior cingulate gyrus damage and.its correlation with the change of cognition function in patients with Alzheimer＇s disease （AD）. Methods DTI, as well as T1 Flair and T2 Flari were performed in 16 probable AD patients and 12 healthy volunteers to measure the fractional anisotropy （FA）, mean diffusivity （MD） and characteristis values of λ1, λ2 and λ3 in the posterior cingulate gyrus. Correlation analysis was applied to reveal the relationship between values of the FA, MD, λ1, λ2 and λ3 with the MMSE scores. Results In contrast to controls, AD patients had significantly lower FA and significantly higher MD, λ1,λ2 and λ3 in the posterior cingulate gyrus （ all P 〈 0.05 ）. Besides, FA was not correlated with MMSE score （ r = - 0.054, P 〉 0. 05 ）. MD, λ1, λ2 and λ3 of AD patients were strongly negatively correlated with MMSE score（r = - 0. 664, - 0. 643, r =-0.69, r =-0.654 ; all P〈0.01）. Conclusions The posterior cingulated gyrus of AD patients are impaired, and the extent of damage is strongly nagetive correlate with the cognition function. This impairment may reflect the cortico-cortical and cortico-subcortical disconnections in the athomechanism of AD. DTI can use to monitor the AD progression and evaluatie the drug efficacy in vivo.

关 键 词：ALZHEIMER病 扣带回后部 磁共振扩散张量成像 部分各向异性分数 平均扩散度 

分 类 号：R749.16[医药卫生—神经病学与精神病学]