不同MoCA评分下血管性认知障碍患者的灰质体积差异基于体素的形态学分析  

A voxel-based morphometry(VBM)study of gray matter volume in patients with vascular cognitive impairment according to different MoCA scores

作　　者：李凯琳 魏翔宇 LI Kailin;WEI Xiangyu(Fourth Clinical Medical College,Guangzhou University of Chinese Medicine,Shenzhen 518033,China;Department of Acupuncture and Moxibustion,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Acupuncture and Anesthesia,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]广州中医药大学附属第四临床医学院/广州中医药大学同等学力申请硕士人员,广东深圳518033 [2]上海中医药大学附属曙光医院针灸科,上海201203 [3]上海中医药大学附属曙光医院针刺麻醉研究所,上海201203

出　　处：《中国中西医结合影像学杂志》2024年第2期143-148,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年项目(82205267)。

摘　　要：目的:采用基于体素的形态学分析(VBM)方法,探究血管性认知障碍(VCI)患者灰质体积与认知障碍程度的关系。方法:选取157例确诊的VCI患者,根据蒙特利尔认知量表(MoCA)评分结果分为轻、中、重度组,均行颅脑MRI扫描和VBM分析。比较3组的颅脑总体积、灰质体积、白质体积、脑室或脑脊液体积,以及灰/白质体积与颅脑总体积之比。对组间差异脑区灰质体积与MoCA评分行相关性分析。结果:与轻度组相比,重度组右侧颞下回、右侧颞中回、右侧额中回、右侧额下回、右侧海马、右侧补充运动区和左侧中央旁小叶的脑灰质体积均显著减少(均P<0.05)。全部患者脑灰质体积与MoCA评分呈正相关(r=0.249,P<0.001);右侧海马区灰质体积与MoCA评分呈正相关(r=0.432,P<0.001)。结论:不同认知功能障碍水平的VCI患者存在额叶、颞叶、顶叶和海马等多个脑区的灰质体积变化,这为认知障碍程度的划分提供了神经影像学证据支持。Objective:To explore the relationship of the gray matter volume and the degree of cognitive impairment in patients with vascular cognitive impairment(VCI)by the voxel-based morphometry(VBM)method.Methods:A total of 157 VCI patients were divided into the mild,moderate and severe groups based on the score of Montreal Cognitive Assessment(MoCA).All patients underwent MRI scan and VBM analysis.Finally,the volumes of total intracranial,gray matter,white matter,ventricle/cerebrospinal fluid and the ratio of the gray/white matter volume to the total intracranial volume were compared among the three groups.The correlations between gray matter volumes of different brain regions and MoCA score were analyzed.Results:Compared with the mild group,the gray matter volumes in the right inferior temporal gyrus,right middle temporal gyrus,right middle frontal gyrus,right inferior frontal gyrus,right hippocampus,right supplementary motor area and left paracentral lobule were significantly lower in the severe group(all P<0.05).There was a positive correlation between gray matter volume and MoCA score(r=0.249,P<0.001).The gray matter volume in the right hippocampus was positively correlated with the MoCA score(r=0.432,P<0.001).Conclusions:VCI patients with different levels of cognitive impairment have gray matter volume changes in the frontal lobe,temporal lobe,parietal lobe and hippocampus.From the perspective of gray matter volume differences,this study provides neuroimaging evidence supporting the classification to the degree of cognitive impairment.

关 键 词：血管性认知障碍 灰质 蒙特利尔认知量表 基于体素的形态学测量 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]