无症状性大脑中动脉狭窄的磁共振灌注变化和认知障碍的相关性观察  

Correlation between MRI perfusion and cognitive impairment in asymptomatic middle cerebral artery stenosis

作　　者：刘东清 张龙 潘蕊 梁可可[3] 赵建华[3] 黄勇华[4] 徐罗 LIU Dong-qing;ZHANG Long;PAN Rui;LAING Ke-ke;ZHAO Jian-hua;HUANG Yong-hua;XU Luo(Xinxiang Medical College,Xinxiang,Henan 453003;不详)

机构地区：[1]新乡医学院,河南新乡453003 [2]郑州颐和医院,郑州450000 [3]河南省人民医院神经内科 [4]濮阳市油田总医院放射科,河南濮阳457000

出　　处：《医药论坛杂志》2020年第12期38-41,45,共5页Journal of Medical Forum

摘　　要：目的通过比较无症状性大脑中动脉狭窄患者脑血流灌注降低与认知功能障碍之间的变化,分析它们之间的相关性。方法行磁共振检查发现单侧大脑中动脉中重度狭窄,并且既往无TIA与脑卒中的狭窄组患者57例,与无颅内血管狭窄的正常组44例,进行一般资料、MMSE、MoCA评分以及磁共振参数方面的对照分析。比较两组间MMSE、MoCA各领域评分及灌注参数值rMTT、rCBF的变化。结果组间一般资料比较差异无统计学意义(P>0.05)。①狭窄组和正常注组MMSE总分分别为(25.48±1.01),(29.28±0.98),MOCA总分为(21.84±1.21)、(28.96±0.89),差异有统计学意义(P<0.05)。②狭窄组与正常组MMSE认知域中定向力、计算力、记忆力比较(P<0.05)。狭窄组与正常组MoCA各项认知域评分有差异(P<0.05)。③狭窄组43例单侧MCA供血区rMTT、rCBF均异常;9例仅rMTT异常,rCBF正常;5例rMTT、rCBF均未见异常。正常组均未见异常。结论无症状性单侧大脑中动脉中重度狭窄患者的认知功能可能受到损害,并且认知损害可能与狭窄侧血管引起的低灌注有关。Objective To analyze the correlation between reduced cerebral blood flow perfusion and cognitive dysfunction in asymptomatic middle cerebral artery stenosis.MethodsμRI examination showed moderate to severe unilateral middle cerebral artery stenosis in 57 patients in the stenosis group without TIA and stroke,and 44 patients in the normal group without intracranial vascular stenosis.General data,MMSE,MoCA score and MRI parameters were compared.The MMSE,MoCA scores and perfusion parameter values of rMTT and rCBF were compared between the two groups.Results There was no statistically significant difference in general data between groups(P<0.05).①The MMSE total scores of the stenosis group and the normal injection group were(25.48±1.01)and(29.28±0.98),respectively,and the MOCA total scores were(21.84±1.21)and(28.96±0.89),respectively,with statistically significant differences(P<0.05);②Comparison of MMSE cognitive domain orientation,computational power,and memory between the stenosis group and the normal group(P<0.05).MoCA scores in various cognitive domains were different between the stenosis group and the normal group(P<0.05).③The rMTT and rCBF of 43 patients with unilateral MCA in the stenosis group were abnormal;Only rMTT was abnormal and rCBF was normal in 9 cases.No abnormality was found in rMTT and rCBF of the 5 patients.No abnormality was observed in the normal group.Conclusion Cognitive function may be impaired in patients with moderate and severe asymptomatic unilateral MIDDLE cerebral artery stenosis,and cognitive impairment may be related to the hypoperfusion induced by the stenosis.

关 键 词：大脑中动脉狭窄 磁共振 灌注 认知障碍 

分 类 号：R743.1[医药卫生—神经病学与精神病学]