DTI对不同程度脑白质疏松患者认知功能的评估价值  

Value of diffusion tensor imaging in evaluating cognitive function of patients with leukoaraiosis at varying degrees

作　　者：朱灿敏 张弦 李强 张媚 曾伟 欧舒春 黄晓倩 Zhu Canmin;Zhang Xian;Li Qiang;Zhang Mei;Zeng Wei;Ou Shuchun;Huang Xiaoqian(Department of Neurology,Fifth Hospital of Wuhan,Wuhan 430050,China)

机构地区：[1]武汉市第五医院神经内科,430050

出　　处：《中华神经医学杂志》2021年第11期1135-1141,共7页Chinese Journal of Neuromedicine

基　　金：武汉市卫生健康科研基金(WX19D38)。

摘　　要：目的:探讨弥散张量成像(DTI)对脑白质疏松(LA)患者认知功能的评估价值。方法:前瞻性选取武汉市第五医院神经内科自2019年7月至2021年5月收治的LA患者60例,均行头颅MRI检查并根据Fazekas视觉等级评定标准将LA患者分为轻度LA组、中度LA组、重度LA组,每组20例。采用简易精神状态检查量表(MMSE)评估患者的认知功能。采用DTI分析患者额叶、颞叶、枕叶、顶叶、侧脑室前角、胼胝体共6个感兴趣区的部分各向异性(FA)值。比较3组患者的基本资料、认知功能和FA值的差异。根据FA值评定患者的认知功能评分(FA评定值),比较其与MMSE评估的认知功能评分(临床评定值)的差异。结果:(1)轻度LA组、中度LA组和重度LA组患者的年龄、同型半胱氨酸(Hcy)水平依次增加,差异均有统计学意义(P<0.05)。与轻度LA组和中度LA组比较,重度LA组患者的受教育年限降低,差异有统计学意义(P<0.05)。(2)轻度LA组、中度LA组和重度LA组患者的记忆力评分依次降低,差异均有统计学意义(P<0.05)。与轻度LA组和中度LA组比较,重度LA组患者的MMSE总分、回忆力评分降低,差异均有统计学意义(P<0.05)。(3)轻度LA组、中度LA组和重度LA组患者顶叶FA值、胼胝体FA值依次降低,差异均有统计学意义(P<0.05)。与轻度LA组和中度LA组比较,重度LA组患者额叶FA值、颞叶FA值、枕叶FA值、侧脑室前角FA值均降低,差异均有统计学意义(P<0.05)。(4)除注意与计算力评分外,轻度LA组患者各认知功能评分的FA评定值和临床评定值差异均无统计学意义(P>0.05)。除语言功能力评分及总分外,中度LA组患者各认知功能评分的FA评定值和临床评定值差异均无统计学意义(P>0.05)。除地点定向力、注意与计算力评分外,重度LA组患者各认知功能评分的FA评定值和临床评定值差异均有统计学意义(P<0.05)。结论:LA的严重程度与患者年龄、Hcy水平、受教育年限和认�Objective To investigate the value of diffusion tensor imaging(DTI)in evaluating the cognitive function of patients with leukoaraiosis(LA).Methods A prospective study was chosen.Sixty patients with LA admitted to our hospital from July 2019 to May 2021 were selected.All patients accepted brain MRI.According to Fazekas visual grading standards,these 60 LA patients were divided into mild LA group,moderate LA group,and severe LA group(n=20).Mini-mental state examination(MMSE)was used to evaluate the cognitive function of these patients.Diffusion tensor imaging was used to analyze the fractional anisotropy(FA)values of 6 regions of interest,namely the frontal lobe,temporal lobe,occipital lobe,parietal lobe,anterior horn of lateral ventricle,and corpus callosum.The differences of general data,cognitive function and FA values among the 3 groups were compared.The cognitive functions were assessed based on FA values(FA scores),and compared with those evaluated by MMSE(clinical scores).Results(1)Age and homocysteine(Hcy)level of patients in mild,moderate and severe LA groups were increased successively,with statistical differences(P<0.05).As compared with that in the mild and moderate LA groups,the educational level of patients in the severe LA group was significantly lower(P<0.05).(2)Memory scores of patients in mild LA group,moderate LA group and severe LA group decreased successively,with statistical differences(P<0.05).As compared with mild LA group and moderate LA group,MMSE total scores and recall scores in severe LA group were statistically decreased(P<0.05).(3)FA values of parietal lobe and corpus callosum were successively decreased in mild,moderate and severe LA groups,with significant differences(P<0.05).As compared with those in the mild and moderate LA groups,the FA values of frontal lobe,temporal lobe,occipital lobe and anterior horn of lateral ventricle in severe LA group were significant decreased,(P<0.05).(4)There were no significant differences in FA scores and clinical scores of cognitive function score

关 键 词：脑白质疏松 弥散张量成像 认知功能 感兴趣区 部分各向异性 

分 类 号：R742[医药卫生—神经病学与精神病学]