采用多参数MRI分析探讨皮质下脑小血管病的脑区体积占比及功能连接变化  

Multiparametric MRI Analysis to Explore the Volume Proportion and Functional Connectivity Changes of Brain Regions in Subcortical Ischemic Vascular Disease

作　　者：张一铭 胡颖 谢祯晖 孙雅文[1] 韩旭[1] 汪耀[1] 裘雅各 周滟[1] ZHANG Yiming;HU Ying;XIE Zhenhui;SUN Yawen;HAN Xu;WANG Yao;QIU Yage;ZHOU Yan(Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine)

机构地区：[1]上海交通大学医学院附属仁济医院放射科

出　　处：《中国医学计算机成像杂志》2023年第3期236-240,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金(82171885);上海市自然科学基金(20ZR1433200);上海市科委探索者计划(21TS1400700);上海市卫生健康委员会卫生健康领军人才(2022LJ023)。

摘　　要：目的:联合3D⁃T1WI高分辨率磁共振成像及静息态功能磁共振成像(rs⁃fMRI)分析,探讨皮质下缺血性脑小血管病(SIVD)患者脑区体积的差异,并进一步做功能连接分析,以及分析两者与认知评分的相关性,以期获得对认知受损具有重要意义的脑结构及功能改变。方法:将107例轻度认知功能障碍(MCI)患者、26例血管性痴呆(VD)患者及65例无认知损害(NCI)的SIVD患者纳入研究。对所有被试行3D⁃T1WI MRI、rs⁃fMRI扫描。分析3组间脑区体积占比,并计算差异脑区间的功能连接(FC)。计算前两者结果与临床认知评分之间的关系。结果:VD组左侧丘脑占比显著小于NCI和MCI组(P<0.001),MCI组右侧尾状核占比大于NCI组(P=0.01);VD组左侧丘脑与右侧尾状核之间的静息态功能连接较MCI组显著减弱(P=0.04)。相关性分析结果显示,MCI组左侧丘脑体积比与听觉词语学习测验短时延迟回忆(AVLT4)评分呈正相关,与注意⁃执行功能交替连线试验A(TMT⁃A)评分呈负相关(r=0.19,P=0.05;r=-0.22,P=0.03)。结论:不同认知损害程度的SIVD患者存在左侧丘脑与右侧尾状核体积的差异,丘脑的体积改变可能与SIVD患者特定的认知领域功能的损害有关。Purpose:To investigate the differences in the volume proportion of brain regions in subcortical ischemic vascular disease(SIVD)patients using combined 3D-T1WI high-resolution magnetic resonance imaging and resting-state functional magnetic resonance imaging(rs-fMRI)analysis,and to further analyze the functional connectivity and the correlation with the cognitive scores,with the aim of obtaining brain structures that are important for cognitive impairment.Methods:A total of 107 patients with mild cognitive impairment(MCI),26 patients with vascular dementia(VD),and 65 SIVD patients with no cognitive impairment(NCI)were recruited in this study.All patients underwent 3D-T1WI MRI,rs-fMRI scans.The volume proportion of brain regions between above 3 groups was analyzed and the functional connectivity(FC)between the differential brain regions were calculated.Then the relationship between the first two results and clinical cognitive scores were analyzed.Results:The left thalamic volume proportion was significantly smaller in the VD group than that in the NCI and MCI groups(P<0.001),and the right caudate nucleus volume ratio was larger in the MCI group than that in the NCI group(P=0.01);the resting-state FC between the left thalamus and the right caudate nucleus was significantly weaker in the VD group than that in the MCI group(P=0.04).Correlation analysis showed that the left thalamic volume proportion in the MCI group was positively correlated with short-term delayed recall of auditory verbal learning test(AVLT4)score and negatively correlated with attention-executive function of trail-making test A(TMT-A)score(r=0.19,P=0.05;r=−0.22,P=0.03).Conclusions:Differences in left thalamus and right caudate nucleus volume proportions exist in SIVD patients with different degrees of cognitive impairment,and altered thalamic volume proportions may be associated with impairment in specific cognitive domains of function in SIVD patients.

关 键 词：皮质下缺血性脑小血管病 认知障碍 丘脑 多参数磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]