血管性认知障碍各亚型患者认知功能差异及磁共振弥散张量成像参数的改变  

Cognitive Function Differences of Patients with Vascular Cognitive Impairment and Changes in Magnetic Resonance Diffusion Tensor Imaging Parameters

作　　者：何庆建[1] 马周鹏 赵芳[1] He Qingjian;Ma Zhoupeng;Zhao Fang(Tha First Affiliated Hospital of Xiamen University,Fujian 361000;Shanghai Jinshan Distmct Hospital of Intearated Traditional Chinese and Western Medicine,Shanghao201599)

机构地区：[1]厦门大学附属第一医院,福建361000 [2]上海市金山区中西医结合医院,上海201599

出　　处：《现代医用影像学》2022年第2期204-209,共6页Modern Medical Imageology

摘　　要：目的:分析血管性认知功能障碍各亚型患者的认知功能及磁共振弥散张量成像参数的差异。方法:选取2019年6月至2020年8月我院136例血管性认知障碍患者作为研究对象并将其设为观察组,另选取136例健康体健者设为对照组,其中观察组分为无痴呆型血管性认知障碍组(46例)、血管性痴呆组(45例)、混合型痴呆组(45例)均给予磁共振检查,通过采用Pearson法分析磁共振弥散张量成像参数与血管性认知障碍各亚型的相关性。结果:观察组精神状态检查表(MMSE)、认知能力筛查量表(CCSE)、双侧海马容积(L-HPV、R-HPV)、双侧内嗅叶皮质容积(L-ECV、R-ECV)均低于对照组(P<0.05),双侧前额角容积(L-FHV、R-FHV)、第三脑室容积(TVV)、双侧颞角容积(L-THV、R-THV)、额叶萎缩、颞叶萎缩、顶叶萎缩、枕叶萎缩、皮质下白质疏松、腔隙性脑梗均高于对照组(P<0.05);而混合型痴呆组与痴呆组MMSE、CCSE评分无差异,(P>0.05),但这两组MMSE、CCSE评分、L-HPV、R-HPV、L-ECV、R-ECV均显著低于无痴呆组(P<0.05);且L-FHV、R-FHV、TVV、L-THV、R-THV均明显高于无痴呆组(P<0.05);而混合型痴呆组额叶、颞叶、顶叶及枕叶萎缩评分明显高于无痴呆组与痴呆组(t=17.803/6.645/37.950/25.379/11.819/4.490/52.947/20.933,P<0.05);而皮质下白质疏松、腔隙性脑梗死程度低于无痴呆组与痴呆组(t=5.408/42.222/7.602/17.176,P<0.05);相关性分析显示:血管性认知障碍各亚型与L-FHV、R-FHV、TVV、L-THV、R-THV、额叶萎缩、颞叶萎缩、顶叶萎缩、枕叶萎缩、皮质下白质疏松、腔隙性脑梗呈正相(r=0.972/0.969/0.942/0.747/0.815/0.955/0.961/0.935/0.993/0.651/0.704,P<0.05);与L-HPV、R-HPV、L-ECV、R-ECV呈负相关(r=-0.578/-0.532/-0.792/-0.751,P<0.05)。结论:磁共振弥散张量成像参数直接反映了血管性认知障碍各亚型患者病理变化,血管性痴呆组与混合型痴呆组的脑组织结构变化明显,即脑叶萎缩程度增加。Objective:To analyze the differences in cognitive function and magnetic resonance diffusion tensor imaging parameters of patients with vascular cognitive dysfunction in each subtype. Methods:From June 2019 to Augus 2020, 136 patients with vascular cognitive impairment(observation group) and 136 healthy people(control group) in our hospital were selected as the research objects, among them, the observation components were the non-dementia-type vascular cognitive impairment group(46 cases), the vascular dementia group(45 cases), and the mixed dementia group(45 cases). All were given MRI.pearson method was used to analyze the correlation between MRI diffusion tensor imaging parameters and various subtypes of vascular cognitive impairment. Results:Observation group mental status checklist(MMSE), cognitive ability screening scale(CCSE), bilateral hippocampal volume(L-HPV, R-HPV), bilateral entorhinal cortex volume(L-ECV, R-ECV) are lower than the control group(P<0.05),Bilateral frontal horn volume(L-FHV, R-FHV), third ventricle volume(TVV), bilateral temporal horn volume(L-THV, R-THV), frontal lobe atrophy, temporal lobe atrophy, parietal lobe atrophy, Occipital lobe atrophy, subcortical white matter looseness, and lacunar cerebral infarction were higher than those in the control group(P<0.05);There was no difference in MMSE and CCSE scores between the mixed dementia group and the dementia group(P>0.05), but the MMSE, CCSE scores, L-HPV, R-HPV, L-ECV, and R-ECV of the two groups were lower than those of the no dementia group(P<0.05);L-FHV, R-FHV, TVV, L-THV and R-THV were all higher than those without dementia(P<0.05);The scores of frontal lobe atrophy, temporal lobe atrophy, parietal lobe atrophy, and occipital lobe atrophy in the mixed dementia group were higher than those of no dementia group and the dementia group(t=17.803/6.645/37.950/25.379/11.819/4.490/52.947/20.933,P<0.05);The degree of subcortical leukoaraiosis and lacunar cerebral infarction was lower than that of the non-dementia group and the dementia grou

关 键 词：血管性认知障碍 亚型 认知功能 磁共振弥散张量成像 参数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.13[医药卫生—诊断学]