经神经影像学支持的阿尔茨海默病脑白质改变的磁共振弥散张量成像研究  

The study of diffusion tenson imaging on detecting white matter alteration of Alzheimer disease on the basis of neuroimaging result

作　　者：徐敏[1] 怀德 陈君坤[1] 林千早 魏玲[1] 马林[1] 

机构地区：[1]江苏省淮安市第二人民医院影像科,223002 [2]江苏省淮安市第二人民医院耳鼻咽喉头颈外科,223002

出　　处：《中华临床医师杂志（电子版）》2015年第13期32-36,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过磁共振弥散张量成像(DTI)对阿尔茨海默病(AD)患者脑白质损伤变化及认知功能情况分析,探讨其变化关系。方法应用3.0 T DTI对20例AD患者和20名健康老人行轴位全脑DTI扫描,比较两组脑部各向异性分数(FA)的差异,分析AD患者各被检测部位的FA值、弥散系数(D)值与功能变化的相关性。结果 (1)AD组胼胝体压部(CCP)白质FA值下降,差异有统计学意义(t=2.461,P<0.05),AD组CCP D值提高,差异有统计学意义(t=1.741,P<0.05)。(2)AD组白质FA、D值与简易智能状态检测(MMSE)及形象记忆测试(FMT)评分均显著相关。AD患者CCP、脑部扣带(C-M、C-P)白质FA与MMSE、FMT评分测试呈正相关(r值分别为0.405、0.334、0.376、0.372、0.368、0.365,均P<0.05),CCP、C-M、C-P的D值与神经心理测试评分呈负相关(r值分别为-0.366、-0.336、-0.403、-0.367、-0.332、-0.403,均P<0.05)。结论 AD患者脑内可能存在多部位细微结构和神经改变,DTI检测指标可考虑作为指导临床治疗客观参考诊断标准之一。Objective To study the white matter structure alteration and cognitive function via the diffusion tensor MR images in the Alzheimer disease patients, in order to explore their changing regularity and correlation between them.Methods The diffusion tensor MR images were obtained in 20 AD patients and 20 healthy persons as the control groups, voxel-based analysis was applied to assess the fractional anisotropy （FA） in cerebral tissues. The correlation coefficients between FA, D and the cognitive function in AD patients were calculated.Results The results of AD group showed that FA significantly decreased in posterior corpus callosum （CCP）, the difference was statistically significant （t=2.461,P〈0.05）. The AD group of D significantly increased in posterior corpus callosum （CCP）, the difference was statistically significant （t=1.741,P〈0.05）. There was significant correlation between the FA positively correlated with several tests scores mainly in D and the scores of MMSE and FMT, the FA correlated positively with several tests scores mainly in CCP, C-M, C-P （r=0.405,r=0.334,r=0.376,r=0.372, r=0.368,r=0.365, respectively,P〈0.05）; the D, CCP, C-M and C-P negatively correlated with several tests scores in multiple locations （r=-0.366,r=-0.336,r=-0.403,r=-0.367,r=-0.332,r=-0.403, respectively, P〈0.05）.ConclusionThere are minute nerve structure and neurochemical changes in multiple locations of cerebral tissues in major AD patients, it is possible that the DTI may provide some objective substrates to guiding clinical management.

关 键 词：磁共振成像 弥散 阿尔茨海默病 脑白质 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]