轻度认知障碍患者内侧颞叶微结构变化的磁共振扩散峰度成像研究  

Magnetic resonance diffusion kurtosis imaging of microstructural changes in the medial temporal lobe in patients with mild cognitive impairment

作　　者：王倩楠 孙慧勤[2] 孙卫红[2] 白胜杰 宋璞[2] 赵莉[2] 李晨旭 张青山 WANG Qiannan;SUN Huiqin;SUN Weihong;BAI Shengjie;SONG Pu;ZHAO Li;LI Chenxu;ZHANG Qingshan(Graduate School of Bengbu Medical College,Bengbu 233030,China;Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233030 [2]徐州市中心医院,江苏徐州221009

出　　处：《中国实用神经疾病杂志》2022年第3期283-288,共6页Chinese Journal of Practical Nervous Diseases

基　　金：徐州市科技计划项目(编号:KC19177)。

摘　　要：目的探讨磁共振扩散峰度成像(DKI)技术在轻度认知障碍(MCI)患者内侧颞叶微结构变化中的临床应用价值。方法选取2020-08—2021-11于徐州市中心医院神经内科就诊的脑小血管病患者45例,采用蒙特利尔认知评估量表(MoCA)对患者总体认知功能进行评估,根据是否存在MCI分为MCI组(22例)和无MCI组(23例)。所有患者均行常规MRI形态学及DKI扫描。选择患者内侧颞叶为感兴趣区,包括双侧嗅皮质、海马和海马旁回,比较2组间的差异,并进行相关性分析。结果无MCI组MoCA评分高于MCI组,2组间差异具有统计学意义(P<0.05);性别、年龄、接受教育时间差异无统计学意义(P>0.05)。MCI组患者双侧嗅皮质、海马及海马旁回的AD、MD、RD较无MCI组明显增加,差异有统计学意义(P<0.05),MCI组患者双侧嗅皮质、海马及海马旁回的FA、AK、MK、RK及KFA值较无MCI组明显降低,差异有统计学意义(P<0.05)。MCI组患者左侧海马的FA、MK、RK、KFA值与右侧相比明显增加,差异具有统计学意义(P<0.05)。MCI组患者双侧嗅皮质区、海马及海马旁回AD、MD、RD值与MoCA评分均呈负相关(P<0.05),FA、AK、MK、RK、KFA与MoCA评分均呈正相关(P<0.05)。结论DKI技术可作为观察轻度认知障碍患者内侧颞叶微结构变化的一种有效方法,其相关参数对于MCI患者的临床影像学评估具有一定的应用价值。Objective To investigate the clinical value of diffusion kurtosis imaging(DKI)in the microstructure of medial temporal lobe in patients with mild cognitive impairment(MCI).Methods Forty-five patients with small cerebrovascular disease treated in the Department of Neurology of Xuzhou Central Hospital from August 2020 to November 2021 were selected.The overall cognitive function of the patients was evaluated by Montreal cognitive assessment scale(MoCA).According to the existence of MCI,they were divided into MCI group(22 cases)and no MCI group(23 cases).All patients underwent routine MRI morphology and DKI scanning.The medial temporal lobe of the patient was selected as the region of interest,including bilateral olfactory cortex,hippocampus and parahippocampal gyrus.The DKI related parameters of each region of interest were measured,the differences between the two groups were compared,and the correlation was analyzed.Results The MoCA score of non MCI group was higher than that of MCI group,and the difference between the non MCI group and MCI group was statistically significant(P<0.05).There was no significant difference in gender,age and education time(P>0.05).The AD,MD and RD values of bilateral olfactory cortex,hippocampus and parahippocampal gyrus in MCI group were significantly higher than those in non MCI group(P<0.05).The FA,AK,MK,RK and KFA values of bilateral olfactory cortex,hippocampus and parahippocampal gyrus in MCI group were significantly lower than those in non MCI group(P<0.05).The values of FA,MK,RK and KFA in the left hippocampal region in MCI group were significantly higher than those in the right(P<0.05).The AD,MD and RD values of bilateral olfactory cortex,hippocampus and parahippocampal gyrus in MCI group were negatively correlated with MoCA score(P<0.05),and FA,AK,MK,RK and KFA were positively correlated with MoCA score(P<0.05).Conclusion DKI technique can be used as an effective method to observe the changes of medial temporal lobe microstructure in patients with mild cognitive impairment,an

关 键 词：轻度认知障碍 内侧颞叶 磁共振成像 扩散峰度成像技术 

分 类 号：R749.13[医药卫生—神经病学与精神病学]