深部脑白质缺血与轻度认知功能障碍MR扩散张量成像的相关性  

Correlation Between Deep Brain White Matter Ischemia and MR Diffusion Tensor Imaging of Mild Cognitive Impairment

作　　者：雷立存[1] 杜亚强[2] 何丽[1] 王伟秀[1] 武延华[3] 郭欣珊[1] 

机构地区：[1]河北医科大学第一医院放射科,河北石家庄050031 [2]河北医科大学第四医院放射科,河北石家庄050031 [3]邯郸市第一医院,河北邯郸056000

出　　处：《中国医学影像学杂志》2013年第10期737-740,共4页Chinese Journal of Medical Imaging

基　　金：河北省科技厅科技基金项目(10276169)

摘　　要：目的探讨轻度认知功能障碍(MCI)患者MR扩散张量成像(DTI)脑白质变化及其与认知功能障碍之间的关系。资料与方法 MCI患者40例,分为A组(伴深部脑白质缺血患者20例)和B组(无深部脑白质缺血患者20例)以20例认知功能正常者作为对照组。分别行常规MR、DTI检查及简易精神状态量表、蒙特利尔认知评估量表(MoCA)测试,比较3组患者脑白质的各向异性分数(FA)值和表观扩散系数(ADC)值的差异,并分析A、B组MCI患者的MoCA评分差异。结果与B组比较,A组额叶ADC值升高、FA值降低,顶叶ADC值升高、FA值降低;MoCA评分降低,差异有统计学意义(t=-4.229、-3.251、-7.533、-2.702、-2.660,P<0.05)。与对照组比较,B组额叶ADC值升高,FA值降低,海马旁回ADC值升高,FA值降低,差异有统计学意义(t=-7.790、-2.785、-4.415、-5.164,P<0.05)。结论 MR DTI可以反映MCI患者的脑白质变化,早期发现常规MRI检查无法发现的脑白质异常。伴有深部脑白质缺血患者的脑白质损伤更严重,更易发展为痴呆。Purpose To investigate the correlation between the brain white matter changes of MR diffusion tensor imaging （DTI） and cognitive function in the patients with mild cognitive impairment. Materials and Methods The patients （40 cases） were classified into two groups： group A （20 patients with ischemic tbci in the deep white matter ） and group B （20 patients without ischemic foci in the deep white matter）, and 20 normal controls was enrolled. Conventional MRI, DTI, mini-mental state examination （MMSE） and montreal cognitive assessment （MoCA） were applied, then fractional anisotropy （FA） value and apparent diffusion coefficient （ADC） value were compared among three groups. The scores of MoCA was analyzed between the patient groups. Results The decreased FA value, increased ADC value and decreased MoCA scores was demonstrate in group A, and showed significant difference compared with group B （t=-4.229, -3.251, - 7.533, -2.702, -2.660; P〈0.05）. The increased ADC value and decreased FA value in the frontal and hippocampus region were detected in group B compared with normal controls （t=- - 7.790, - 2.785, - 4.415, - 5.164; P〈0.05）. Conclusion The early and special structural changes can be detected using DTI compared with conventional MRI. The severe white matter lesions can be demonstrated in the patients with ischemic fbci in the deep white matter, who is prone to dementia.

关 键 词：脑缺血 脑白质 认知障碍 磁共振成像 弥散 扩散张量成像 表观扩散系数 

分 类 号：R455.2[医药卫生—运动医学]