动脉自旋标记成像技术联合认知评分诊断阿尔茨海默病研究  

Application of arterial spin-labeled imaging combined with cognitive score in diagnosis of AD

作　　者：王子含 闫少珍 崔碧霄[1] 杨宏伟 齐志刚[1] 卢洁[1] Wang Zihan;Yan Shaozhen;Cui Bixiao;Yang Hongwei;Qi Zhigang;Lu Jie(Department of Radiology and Nuclear Medicine,Affiliated Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《中华老年心脑血管病杂志》2022年第2期171-175,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81801677);北京市科技计划项目(Z201100005520018);北京市医院管理局“登峰”项目(DFL20180802)。

摘　　要：目的探讨阿尔茨海默病(AD)和轻度认知功能障碍(MCI)患者脑血流灌注改变的模式,选用动脉自旋标记(ASL)MRI灌注成像技术,同时联合简易智能状态检查量表(MMSE)评分诊断评估。方法收集2017年6月~2019年12月首都医科大学宣武医院就诊的AD患者19例(AD组),MCI患者37例(MCI组),同时收集我院健康体检者23例(对照组)。行MMSE评估和ASL-MRI检查。比较3组感兴趣区脑血流量(CBF)差异,选取ROC曲线计算感兴趣区CBF及其联合MMSE评分鉴别各组的敏感性、特异性和曲线下面积(AUC)。结果与对照组比较,AD组双侧后扣带回、左侧海马和右侧楔前叶CBF明显减低(P<0.05,P<0.01)。与MCI组比较,AD组左侧和右侧后扣带回CBF明显减低[(48.36±6.52)ml/(min·100 g)vs(53.27±7.76)/ml(min·100 g);(47.35±5.89)ml/(min·100 g)vs(52.92±8.67)ml/(min·100 g),P<0.05]。ROC曲线分析显示,左侧后扣带回CBF鉴别AD组与对照组的敏感性和AUC最高(86.96%和0.78);CBF联合MMSE评分可提高鉴别AD组与对照组的敏感性、特异性和AUC(91.30%、84.21%和0.89)。右侧后扣带回CBF鉴别AD组与MCI组的AUC最高(0.68);CBF联合MMSE评分可提高鉴别AD组与MCI组AUC(0.73)。结论基于ASL-MRI灌注成像技术有助于AD和MCI早期诊断,CBF联合MMSE评分可提高鉴别AD的准确性,为临床诊断AD提供影像学依据。Objective To assess the diagnosis of AD and MCI using arterial spin-labeled(ASL)-MRI technique combined with MMSE scale score by studying their changing cerebral blood flow(CBF) perfusion patterns.Methods Nineteen AD patients and 37 MCI patients admitted to our hospital from June 2017 to December 2019 served as AD group and MCI group respectively with 23 subjects who underwent physical examination in our hospital during the same period served as a control group.The differences in their CBF in regions of interest were compared.The CBF in regions of interest was measured by ROC curve analysis.The sensitivity, specificity and AUC in different groups were identified by ROC curve analysis combined with MMSE scale score.Results The CBF in bilateral posterior cingulate gyrus, left hippocampus and right precuneus was significantly slower in AD group than in control group(P<0.05,P<0.01).The CBF in left and right posterior cingulate gyrus was significantly slower in MCI group than in AD group [(48.36±6.52)ml/(min·100 g) vs(53.27±7.76)/ml(min·100 g),(47.35±5.89)ml/(min·100 g) vs(52.92±8.67)/ml(min·100 g),P<0.05].ROC curve analysis showed that the CBF in left posterior cingulate gyrus identified the highest sensitivity and the largest AUC in AD group and control group(86.96% and 0.78).CBF combined with MMSE scale score increased the sensitivity, specificity and AUC in AD group and control group(91.30%,84.21% and 0.89).The CBF in right posterior cingulate gyrus identified the largest AUC in AD group and MCI group(0.68).CBF ombined with MMSE scale score increased the AUC in AD group and MCI group(0.73).Conclusion ASL-MRI perfusion imaging technique contributes to the early diagnosis of AD and MCI.CBF combined with MMSE scale score can improve the diagnosis accuracy of AD and provide the evidence for clinical diagnosis of AD.

关 键 词：自旋标记物 阿尔茨海默病 磁共振成像 脑血管循环 

分 类 号：R749.16[医药卫生—神经病学与精神病学]