脑微出血磁敏感加权成像检出情况及其与认知功能的关系  

The Detection of Cerebral Microbleeds by Susceptibility Weighted Imaging and the Relationship between Cerebral Microbleeds and Cognitive Function

作　　者：肖桂荣[1,2] 孙新芳[1,2] 王赵伟[1,2] 

机构地区：[1]浙江省绍兴市人民医院 [2]浙江大学绍兴医院神经内科,312000

出　　处：《中国全科医学》2014年第21期2532-2535,共4页Chinese General Practice

摘　　要：目的探讨磁敏感加权成像(SWI)对脑微出血(CMBs)的检出情况及CMBs对认知功能的影响。方法选取2012年1月—2013年8月在绍兴市人民医院神经内科住院及门诊行SWI检查确诊CMBs的患者50例为CMBs组,另选取同时期性别、年龄、文化水平相匹配的SWI未见微出血灶的体检者44例为对照组,使用蒙特利尔认知评定量表(MoCA)评价其认知功能,比较两组患者MoCA评分情况及不同级别和部位的CMBs引起的认知功能障碍情况。结果 CMBs在SWI上主要表现为脑实质内边界清晰的小圆形低信号影。CMBs组患者MoCA总分、视空间执行能力、命名、注意力、语言、抽象能力、记忆力、定向力均低于对照组(P<0.05)。与对照组比较,轻度CMBs组、中度CMBs组、重度CMBs组MoCA总分、视空间执行能力、抽象能力、记忆力评分降低,中度CMBs组、重度CMBs组命名、注意力、语言评分降低(P<0.05);与轻度CMBs组比较,中度CMBs组、重度CMBs组MoCA总分、注意力、抽象能力、记忆力评分降低,重度CMBs组视空间执行能力、语言评分降低(P<0.05);与中度CMBs组比较,重度CMBs组MoCA总分、视空间执行能力、注意力、语言、记忆力评分降低(P<0.05)。Spearman相关分析显示:CMBs数量与MoCA总分、视空间执行能力、注意力、语言、抽象能力、记忆力评分呈负相关(P<0.05);皮质-皮质下CMBs与MoCA总分、视视空间执行能力、注意力、语言、记忆力评分呈负相关(P<0.05);基底核和丘脑CMBs与MoCA总分、语言评分呈负相关(P<0.05);脑干和幕下CMBs与MoCA总分、视空间执行能力评分呈负相关(P<0.05)。结论 SWI能清楚地显示CMBs;CMBs能引起患者认知功能障碍,不同级别和部位的CMBs引起的认知功能障碍不同。ObjectiveToinvestigatethedetectionofcerebralmicrobleeds（CMBs）bysusceptibilityweightedima-ging（SWI）,andinfluenceofCMBsoncognitivefunction.Methods 50patientswhowereactuallydiagnosedwithCMBsby SWI in inpatient and outpatient departments of neurology , Shaoxing People′s Hospital from January 2012 to August 2013, were selected as CMBs group , during the same period , while 44 sex-, age-and education level -matched physical examination people who were not found to have CMBs by SWI , were selected as control group , their cognitive function was evaluated by MoCA rating scale , MoCA score were compared between the two groups and the cognitive dysfunction caused by CMBs of different regions and different degrees .Results SWI imaging features of CMBs were sharply marginated small round low signal images in brain parenchyma.The total MoCA scores, visuospatial skills and execution function scores , nomenclature scores, attention scores, language scores, abstracting scores, memory scores and directive force scores in CMBs group were significantly lower than those in control group （ P〈0.05 ） .The total MoCA scores , visuospatial skills and execution function scores , abstracting scores and memory scores in mild CMBs group , moderate CMBs group and severe CMBs group were significantly lower than those in control group; Nomenclature scores , attention scores and language scores in moderate CMBs group and severe CMBs group were significantly lower than those in control group （ P〈0.05 ） .The total MoCA scores , attention scores , abstracting scores and memory scores in moderate CMBs group and severe CMBs group were significantly lower than those in mild CMBs group ;Visuospatial skills and execution function scores and language scores in severe CMBs group were significantly lower than those in mild CMBs group （P〈0.05） .The total MoCA scores, visuospatial skills and execution function scores , attention scores, lan-guage scores and memory scores in severe CMBs group were significantly lower than those in

关 键 词：脑出血 磁共振成像 认知 蒙特利尔认知评估量表 

分 类 号：R743.34[医药卫生—神经病学与精神病学]