运用DTI直方图分析血管性认知功能障碍患者正常表现白质损害与认知功能的关系  

Application of Diffusion Tensor Imaging Histogram in the Investigation of the Impaction of Normal Appearing White Matter in Vascular Cognitive Impairment Patients

作　　者：周滟[1] 秦玲娣[1] 徐群[2] 曹玮文 路青[1] 李磊[1] 戈欣[1] 柴伟明[1] 许建荣[1] 

机构地区：[1]交通大学医学院附属仁济医院放射科,上海200127 [2]交通大学医学院附属仁济医院神经内科,上海200127

出　　处：《临床放射学杂志》2009年第8期1060-1064,共5页Journal of Clinical Radiology

基　　金：上海市自然基金资助项目(编号:06ZR14122);上海市重点学科建设资助项目(编号:S30203)

摘　　要：目的利用扩散张量成像(DTI)直方图分析,明确血管性认知功能障碍(VCI)患者的正常表现脑白质(NAWH)损害与认知功能之间的关系。资料与方法对24例VCI患者、18例卒中后无认知功能损害患者(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。计算侧脑室旁高信号灶评分(PVH)和深部白质病变评分(DWMHscore)、病变体积与颅脑内容积的比值、灰质(GM)、白质(WM)、表现正常灰质(NAGM)、NAWM的各向异性分数(FA)和表观扩散系数(ADC)图。结果VCI患者的FA和ADC直方图与Stroke组不同,VCI患者WM及NAWHFA直方图左移、FA峰高增高;ADC直方图右移、峰高降低。两组之间FA值在WM平均值、WM峰位置、NAWM平均值和NAWM峰高存在差异,而ADC值在WM平均值、WM峰位置和NAWM平均值存在差异(P<0.01)。VCI患者NAWH的FA平均值和峰高与言语流畅性测验(VFT)评分存在相关性(P<0.05)。结论VCI患者NAWH存在病变,其病变的严重程度与认知功能损害程度有关,DTI直方图分析可用于评价疾病的严重程度。Objective Studies were carried out to detect damage of normal appearing white matter in patients with vascular cognitive impairment （VCI） using diffusion tensor imaging （DTI） histogram analysis. We also determined the correlations between DTI histogram derived measures and cognitive dysfunction. Materials and Methods Conventional MRI and DTI scans were performed in 24 patients with VCI and 18 age-and sex-matched post-stroke patients without cognitive impairment （stroke group）. The periventricular hyperintensities （PVH） , deep white matter hyperintensity scores （DWMH score） and volume of lesions/brain, apparent diffusion coefficient （ ADC ） and fractional anisotropy （FA） histograms of gray matter（ GM）, white matter（ WM）, normal appearing gray matter （NAGM） and normal appearing white matter （NAWM） were evaluated. Results Analysis showed that the patterns of the ADC and FA histograms of WM and NAWM of the VCI group differed from those of the stroke group. The FA histogram shifted to the left with a higher peak, the average ADC histogram shifted to the right with a lower peak. There was significant difference in Average FA of WM, FA histogram peak location of WM, Average FA of NAWM, FA histogram peak height of NAWM,the Average ADC of WM, the ADC histogram peak location of NAWM and Average ADC of NAWM in patients with VCI and Stroke group （P 〈0.01 ）. There was a correlation between the average FA and the FA histogram peak height in patients with VCI and verbal fluency test （VFT）（ P 〈 0.05）. Conclusion Our findings suggest there is subtle damage in the NAWM in VCI, and the severity of NAWM may be related to cognitive dysfunction.

关 键 词：血管性认知功能障碍 扩散张量成像 直方图分析 表观扩散系数 各项异性分数 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]