皮质下缺血性血管性认知功能障碍的静息态功能磁共振研究  

Resting state functional MRI of subcortical ischemic vascular cognitive impairment

作　　者：郭会映[1,2] 孙芳[1] 张宗军[1] 戚荣丰[1] 倪玲[1] 庞建鑫 

机构地区：[1]南京军区南京总医院医学影像科,210002 [2]徐州医学院影像医学与核医学专业 [3]徐州医学院附属医院影像科

出　　处：《中华老年心脑血管病杂志》2013年第12期1257-1260,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨静息态功能磁共振低频振幅(ALFF)的分析方法在皮质下缺血性血管性认知功能障碍中的价值。方法选择49例缺血性脑小血管病患者经临床痴呆量表评分后,分为血管性痴呆(VaD)组10例,非痴呆型血管性认知功能障碍(VCIND)组20例,认知功能正常为对照组19例。分别采集高分辨率结构像和静息态功能磁共振数据,通过ALFF分析方法计算并对比3组患者脑功能活动的改变。观察VaD组ALFF统计脑图与认知量表评分的相关性。结果与对照组比较,VaD组内侧前额叶、后扣带回及双侧颞叶脑区ALFF明显降低,额中回、额上回、顶下小叶脑区ALFF明显升高,VCIND组内侧前额叶ALFF明显降低,左侧顶叶及颞中回ALFF明显升高(P<0.05);与VCIND组比较,VaD组后扣带回/楔前叶、左侧小脑区ALFF明显降低,双侧额叶、颞叶及前扣带回明显升高(P<0.05);回归灰质体积后,VaD组ALFF统计脑图与多个临床量表评分存在相关性(P<0.05)。结论血管性认知功能障碍患者存在以执行功能障碍为主的多个领域的认知功能障碍,其认知功能障碍可能与额叶-皮质下环路受损有关,ALFF在血管性认知功能障碍及其早期诊断中有重要价值。Objective To study the value of resting state functional MRI in diagnosis of subcortical small vascular cognitive impairment（VCI）. Methods Forty-nine patients with ischemic cerebral small vessel disease were divided into vascular dementia （VaD） group （n=10）,non-dementia VCI group （n=20） and normal cognitive （control） group （n= 19） according to their clinical dementia rating （CDR） score. High resolution structure imaging and resting state functional MRI data wre recorded. Brain activities in 3 groups were assayed. Correlation between brain images and CDR score in VaD group was analyzed. Results The resting state functional MRI amplitude was signif- icantly lower in prefrontal cortex,posterior cingulate and bilateral temporal lobe,and significantly higher in middle frontal gyrus,superior frontal gyrus and inferior parietal lobe in VaD group than in control group and non-dementia VCI group （P〈0.05）. After regression of the gray matter vol- ume,the resting state functional MRI amplitude was changed only in a small brain area. The brain image was significantly correlated with the CDR score in VaD group （P〈0. 05）. Conclusion Cognitive impairement is related with prefrontal and cortical circuit damage in VCI patients. Resting state functional MRI plays an important role in the early diagnosis of VCI.

关 键 词：认知障碍 磁共振成像 痴呆 血管性 额叶 神经心理学测验 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]