血管性认知功能障碍MRI FLAIR序列图像分析及认知功能评估  

MRI FLAIR sequence image analysis and cognitive function evaluation of vascular cognitive dysfunction

作　　者：黄开胜[1] 敖振杰[1] 方桂求[1] 唐宇红 黄柳兰 余映丽[3] HUANG Kai-sheng;AO Zhen-jie;FANG Gui-qiu;TANG Yu-hong;HUANG Liu-lan;YU Ying-li(Department of Radiology,Dongguan Houjie Hospital,Dongguan 523945,Guangdong,CHINA;Department of Neurosurgery,Dongguan Houjie Hospital,Dongguan 523945,Guangdong,CHINA;Department of Neurology,Dongguan Houjie Hospital,Dongguan 523945,Guangdong,CHINA)

机构地区：[1]东莞市厚街医院放射科,广东东莞523945 [2]东莞市厚街医院神经外科,广东东莞523945 [3]东莞市厚街医院神经内科,广东东莞523945

出　　处：《海南医学》2021年第7期827-830,共4页Hainan Medical Journal

基　　金：广东省东莞市社会科技发展(一般)项目(编号:201950715023732)。

摘　　要：目的探讨血管性认知功能障碍(VCI)患者磁共振成像(MRI)、液体衰减反转恢复(FLAIR)序列图像特征,并评估其认知功能。方法选择2019年5月至2020年9月期间东莞市厚街医院收治的55例VCI患者作为研究组,同期在我院体检的健康人员55例作为对照组,比较两组受检者入院后的MRI检查结果[完成前额角容积(FHV)、第三脑室容积(TVV)、颞角容积(THV)、海马容积(HPV)、内嗅叶皮质容积(ECV)]和FLAIR序列检测图像,并采用蒙利尔认知评估表(MoCA)测定受检者的认知功能。结果研究组患者的L-FHV、R-FHV、TVV、L-THV、R-THV、L-HPV、R-HPV的比值分别为0.25±0.07、0.27±0.06、0.16±0.03、0.13±0.02、0.14±0.03、0.10±0.02、0.11±0.03,明显高于对照组的0.18±0.02、0.16±0.03、0.06±0.01、0.08±0.01、0.07±0.01、0.05±0.01、0.06±0.01,差异均有统计学意义(P<0.05);研究组患者的L-ECV、R-ECV的比值分别0.04±0.01、0.04±0.01,与对照组的0.04±0.01、0.04±0.01比较,差异均无统计学意义(P<0.05);研究组患者的额叶萎缩、颞叶萎缩、顶叶萎缩、枕叶萎缩、皮质下白质疏松、腔隙性脑梗死评分分别为(1.65±0.33)分、(1.73±0.56)分、(1.91±0.41)分、(0.65±0.12)分、(1.25±0.43)分、(1.86±0.52)分,明显高于对照组的(1.07±0.21)分、(1.25±0.24)分、(1.06±0.19)分、(0.21±0.04)分、(0.67±0.11)分、(0.85±0.21)分,差异均有统计学意义(P<0.05);两组受检者的FLAIR序列图像检查后,研究组检查出边缘清晰,异常高信号经判断最终确定为病灶的132个,对照组检出11个,研究组明显高于对照组,差异有统计学意义(P<0.05);研究组患者的语言能力、抽象思维、定向力、注意力与计算力、视空间及执行能力、延迟回忆评分分别为(3.18±0.83)分、(0.6±0.93)分、(5.6±0.78)分、(4.4±0.67)分、(3.67±0.69)分、(2.45±0.78分),明显低于对照组的(4.53±0.60)分、(1.3±0.51)分、(6.3±0.82)分、(5.1±0.83)分、(4.90±0.58)分、(3.33±0.63Objective To investigate the characteristics of magnetic resonance imaging(MRI)and fluid attenuated inversion recovery(FLAIR)sequences in patients with vascular cognitive impairment,and to evaluate their cognitive function.Methods A total of 55 patients with vascular cognitive impairment,who admitted to Dongguan Houjie Hospital from May 2019 to September 2020,were selected as the study group,and 55 healthy people who underwent physical examination in the Hospital during the same time were selected as the control group.The MRI examination(measuring for the volume of frontal angle[FHV],third ventricle[TVV],temporal angle[THV],hippocampus[HPV]and entorhinal cortex[ECV]),FLAIR sequence detection images and the cognitive function of patients were compared between the two groups after admission.The cognitive function was measured by the Montreal Cognitive Assessment(MoCA).Results The ratios of L-FHV,R-FHV,TVV,L-THV,R-THV,L-HPV and R-HPV in the study group were 0.25±0.07,0.27±0.06,0.16±0.03,0.13±0.02,0.14±0.03,0.10±0.02,and 0.11±0.03,respectively,which were significantly higher than corresponding 0.18±0.02,0.16±0.03,0.06±0.01,0.08±0.01,and 0.07±0.01,0.05±0.01,0.06±0.01 in the control group(all P<0.05);the ratio of L-ECV and R-ECV in the study group was 0.04±0.01 and 0.04±0.01,and there was no significant difference as compared with 0.04±0.01 and 0.04±0.01 in the control group(P>0.05);the scores of frontal lobe atrophy,temporal lobe atrophy,parietal lobe atrophy,occipital lobe atrophy,subcortical leukoaraiosis and lacunar cerebral infarction in the study group were(1.65±0.33)points,(1.73±0.56)points,(1.91±0.41)points,(0.65±0.12)points,(1.25±0.43)points,(1.86±0.52)points,respectively,which were significantly higher than corresponding(1.07±0.21)points,(1.25±0.24)points,(1.06±0.19)points in the control group(all P<0.05);after FLAIR sequence image examination of the two groups,the edge of the study group was clear and the abnormal high signal was finally determined as 132 lesions versus 11 lesions

关 键 词：血管性认知功能障碍 磁共振成像 液体衰减反转恢复序列 认知功能 临床意义 

分 类 号：R749.1[医药卫生—神经病学与精神病学]