磁共振弥散张量成像在无症状性腔隙性脑梗死患者认知障碍中的应用研究  

Application of diffusion tensor imaging in cognitive impairment of patients with asymptomatic lacunar infarction

作　　者：张强[1] 袁婕[1] 董晓云[1] 张虹[1] 崔小丽[1] 王亚奎[2] ZHANG Qiang;YUAN Jie;DONG Xiaoyun;ZHANG Hong;CUI Xiaoli;WANG Yakui(The First Department of Neurology,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院神经内一科,陕西西安710068 [2]韩城市人民医院影像科,陕西韩城715400

出　　处：《陕西医学杂志》2023年第1期57-61,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2021JQ-903)。

摘　　要：目的:利用磁共振弥散张量成像(DTI)探讨合并认知障碍的无症状性脑梗死患者脑白质结构改变特点。方法:收治住院的28例无症状性腔隙性脑梗死不伴脑白质病变患者,按照蒙特利尔认知评估表(MoCA)大于等于26分分为认知正常组和认知障碍组,住院期间行头颅DTI检查,利用基于兴趣区(ROI)分析方法,测量两组患者同一水平、镜面对称的双侧侧脑室前角、后角、侧脑室体旁、半卵圆中心近腹侧、半卵圆中心近背侧看似正常脑白质的表观弥散系数(ADC)和各向异性分数(FA)值。结果:认知正常组与认知障碍组在右侧侧脑室前角、双侧侧脑室后角、双侧侧脑室体旁、双侧半卵圆中心近腹侧、双侧半卵圆中心近背侧ADC值比较无统计学差异(均P>0.05),但是左侧侧脑室前角ADC值比较差异有统计学意义(P<0.05)。认知正常组与认知障碍组在右侧侧脑室前角、右侧侧脑室后角、左侧侧脑室体旁、左侧半卵圆中心近背侧FA值比较差异无统计学意义(均P>0.05),两组患者在左侧侧脑室前角、左侧侧脑室后角、右侧侧脑室旁、双层半卵圆中心近腹侧、右侧半卵圆中心近背侧FA比较值差异存在统计学意义(均P<0.05)。结论:无症状性脑梗死患者的认知损害,多表现在执行功能、注意力、语言流畅性;左侧侧脑室前角、左侧侧脑室后角、右侧侧脑室旁、双层半卵圆中心近腹侧、右侧半卵圆中心近背侧的白质纤维参与了多个认知域的形成。Objective:To study the characteristics of white matter structure changes in asymptomatic cerebral infarction patients with cognitive impairment by using diffusion tensor imaging(DTI).Methods:The clinical data and DTI parameter of 38 patients with asymptomatic lacunar infarction without white matter lesions were collected retrospectively.These patients were divided into cognitive normal group(MoCA score more than or equal to 26)and cognitive impaired group(MoCA score less than 26).Head DTI was performed in both groups during the hospitalization.Based on the Region-of-interest(ROI)analysis method,the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)values were measured in the following mirror-symmetrical areas with the same level:bilateral anterior horns of lateral ventricles,bilateral posterior horns of lateral ventricles,body of lateral cerebral para-ventricle,bilateral ventral parts of centrum oval,bilateral dorsal parts of centrum oval.Results:There was no statistically significant difference in ADC values between the two groups in right anterior horn of lateral ventricle,bilateral posterior horns of lateral ventricles,bilateral bodies of lateral cerebral para-ventricle,bilateral ventral and dorsal parts of centrum oval(all P>0.05),while the ADC value of anterior horn of right lateral ventricle was significantly different(P<0.05).Significant differences in FA values existed in the anterior horn of left lateral ventricle,the posterior horn of the left lateral ventricle,the body of right lateral cerebral para-ventricle,bilateral ventricle parts of centrum oval and the right dorsal part of centrum oval between the two groups(all P<0.05),while there was no statistically significant difference in FA value in the anterior horn of right lateral ventricle,the posterior horn fo the right lateral ventricle,the body of left lateral cerebral para-ventricle and the left dorsal part of centrum oval(all P>0.05).Conclusion:Cognitive impairment in patients with asymptomatic cerebral infarction is mostly manifeste

关 键 词：无症状性脑梗死 认知障碍 弥散张量成像 脑白质 表观弥散系数 各向异性分数 

分 类 号：R743[医药卫生—神经病学与精神病学]