双额叶脑代谢物浓度改变与轻度认知功能障碍的磁共振波谱量化研究  

Magnetic resonance spectroscopy quantitative research of changes in bifrontal metabolite concentration and cognitive dysfunction

作　　者：陈杰 肖叶玉 吴美联 梁晓莹 夏学文 Chen Jie;Xiao Yeyu;Wu Meilian;Liang Xiaoying;Xia Xuewen(Department of Medical Imaging,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Department of Medical Imaging,Guangzhou Hospital of Integrated Traditional and West Medicine,Guangzhou 510800,China;Department of Medical Imaging,Shunde Hospital of Southern Medical University,Shunde 528000,China)

机构地区：[1]汕头大学医学院第二附属医院医学影像科,515041 [2]广州市中西医结合医院医学影像科,510800 [3]南方医科大学附属顺德医院医学影像科,528000

出　　处：《中华核医学与分子影像杂志》2021年第2期93-97,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：广东省自然科学基金(2018A0303070002);汕头市科技计划项目(2016-21,2018-25);广州市花都区医疗卫生项目(19-HDWS-001)。

摘　　要：目的用磁共振频谱(MRS)结合LCModel分析软件定量研究轻度认知功能障碍(MCI)患者双额叶脑代谢物浓度的变化及与脑白质脱髓鞘的关系。方法前瞻性收集2016年5月至2018年12月于汕头大学医学院第二附属医院就诊的25例神经心理学测试结果为MCI者,记为A组[男12例,女13例,年龄(60.5±5.2)岁],按MRI结果将其分为有白质脱髓鞘组[A1组,男7例,女4例,年龄(62.1±3.9)岁]和无白质脱髓鞘组[A2组,男5例,女9例,年龄(59.2±5.8)岁]。另选同期15名神经心理学测试结果正常且无白质脱髓鞘者为健康对照组[B组,男6名,女9名,年龄(59.5±3.5)岁]。用LCModel软件对双额叶MRS原始数据进行定量分析,应用两独立样本t检验比较双额叶代谢物N-乙酰天门冬氨酸复合物(NAA)、肌酸复合物(Cr)、胆碱复合物(Cho)、肌醇(mI)的绝对浓度值及NAA/Cr、Cho/Cr、mI/Cr及NAA/mI比值的组间差异,用Person相关分析探究代谢物浓度值与认知功能量表评分间的相关性。结果A组左、右额叶mI(5.19±1.28、4.87±1.11)均较B组升高(4.32±0.83、3.85±0.98;t值:2.34、2.93,均P<0.05);A组右额叶mI/Cr值较B组高(1.19±0.31与0.98±0.25;t=2.21,P<0.05)、NAA/mI值比B组低(1.37±0.34与1.78±0.47;t=-3.16,P<0.01);其余各代谢指标在A、B组间以及A1、A2组间差异均无统计学意义(t值:-1.70~1.35,均P>0.05)。右额叶mI与蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)评分呈负相关(r值:-0.35、-0.38,均P<0.05),右额叶NAA/mI与上述量表评分呈正相关(r值:0.43、0.40,均P<0.05)。结论MCI可能与右额叶神经元脱失或功能障碍有关,MRS在一定程度上可为早期识别MCI提供理论依据。Objective To study the change of bifrontal metabolite concentration in patients with mild cognitive impairment(MCI)and its relationship with substantia alba demyelination using magnetic resonance spectroscopy(MRS)combined with linear combination of model(LCModel)quantitative technique.Methods From May 2016 to December 2018,25 patients with MCI(group A;12 males,13 females,age(60.5±5.2)years)and 15 healthy control subjects(group B;6 males,9 females,age(59.5±3.5)years)in the Second Affiliated Hospital of Shantou University Medical College were prospectively enrolled.The MCI patients were classified into 2 subgroups according to MRI results:group A1 with substantia alba demyelination(7 males,4 females,age(62.1±3.9)years)and group A2 without substantia alba demyelination(5 males,9 females,age(59.2±5.8)years).Software LCModel was used to quantitatively analyze the MRS original data and measure the absolute concentration of N-acetylaspartate compound(NAA),creatine compound(Cr),choline-containing compound(Cho),myoinositol(mI)and ratios of NAA/Cr,Cho/Cr,mI/Cr,NAA/mI in bilateral frontal lobe.Independent-sample t test was used to analyze the inter-group differences of the above parameters,while Pearson correlation analysis was performed to analyze correlations between the above parameters and cognitive function scores.Results Compared with group B,group A had higher mI of both left and right frontal lobes(left:(5.19±1.28)vs(4.32±0.83),right:(4.87±1.11)vs(3.85±0.98);t values:2.34,2.93,both P<0.05);the mI/Cr of right frontal lobe in group A was also higher(1.19±0.31 vs 0.98±0.25;t=2.21,P<0.05),while the NAA/mI of right frontal lobe was lower(1.37±0.34 vs 1.78±0.47;t=-3.16,P<0.01).Differences of other parameters between group A and group B,and those between group A1 and group A2 were not significantly different(t values:-1.70 to 1.35,all P>0.05).The mI of right frontal lobe was negatively correlated with Montreal Cognitive Assessment(MoCA)score and Mini-Mental State Examination(MMSE)score(r values:-0.35,-0.38,both

关 键 词：认知障碍 磁共振成像 弥散 额叶 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]