MRI体积测量内嗅皮层萎缩诊断Alzheimer病的价值  

The diagnostic value of entorhinal cortex atrophy by MR volumetry in Alzheimer′s disease

作　　者：刘树良[1] 李坤成[1] 王亮[1] 杨小平[1] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053

出　　处：《中华放射学杂志》2000年第6期374-377,共4页Chinese Journal of Radiology

摘　　要：目的　评价MRI测量内嗅皮层体积对诊断Alzheimer病 (AD)的价值。方法　对可能AD和正常对照者各 33名进行MRI检查 ,AD患者平均年龄 (6 6 6± 8 8)岁 ,平均简短精神量表 (MMSE)评分 14 3± 4 1,正常对照组平均年龄 (6 6 5± 7 7)岁 ,MMSE评分为 2 8 0± 2 6。应用磁化准备快速梯度回波成像序列获取三维T1 WI,在重建斜冠状层面上进行两侧内嗅皮层、杏仁核、海马结构、海马旁回、颞叶、侧脑室颞角和侧脑室体部等结构的体积测量 ,所得数值经部分颅内体积标准化处理 ,然后用社会科学统计程序行统计学分析。结果　AD患者上述脑实质结构均明显萎缩 ,脑室扩张 (P <0 0 0 05 )。内嗅皮层的萎缩率最高 (左侧 40 1%、右侧 38 2 % ) ,判别AD与正常人的效果最好 (正确率92 4% )。应用逐步判别方法建立多元判别方程 ,根据轻度AD患者的测量结果 ,左内嗅皮层、左颞叶和右杏仁核等指标联合判别 ,诊断AD的正确率为 97 7% ,由中重度AD患者验证此判别方程可靠 (灵敏度 90 9% )。结论　内嗅皮层MRI体积测量是区分AD与正常人的重要指标。Objective To evaluate the diagnostic value of measurements of entorhinal cortices by MRI volumetry for patients with Alzheimer′s disease Methods Thirty three probable patients with Alzheimer′s disease and 33 normal controls have been scanned by MRI, and volumetric measurements of the bilateral entorhinal cortices (EC), amygdala (AMY), hippocampal formations (HF), parahippocampal gyri (PHG), temporal lobes (TL), temporal horns of lateral ventricle (TH), and lateral ventricle bodies (LVB) were done on the serial reconstructed MR images Results All the measurements of cerebral regions were atrophied (ventricles enlarged) significantly in AD group ( P <0 0005) The rates of atrophy of EC were highest (40 1% on the left and 38 2% on the right respectively),and the diagnostic result in differentiating patients with AD from normal controls was best (accuracy 92 4%) After stepwise selection, a compound measurements of left entorhinal cortex, left temporal lobe and right amygdala could discriminate patients with mild AD from normal controls with the accuracy of 97 7%. Cross validation in patients with moderate and severe AD confirmed the reliability of the discriminating function (sensitivity 90 9%) Conclusion The MRI volumetric measurements of entorhinal cortices are highly efficacious in discriminating patients with AD from the normal controls

关 键 词：早老性痴呆 内嗅皮层萎缩 磁共振成像 判别分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]