3D-ASL技术评估脑梗死患者脑白质血流灌注异常情况及与认知功能的相关性分析  

Evaluate the abnormal white matter blood perfusion by 3D-ASL technique and its correlation with cognitive function in patients with cerebral infarction

作　　者：郝巧梅 张海三[2] 马小静[1] 牛振 张勇[3] HAO Qiaomei;ZHANG Haisan;MA Xiaojing;NIU Zhen;ZHANG Yong(MRI Room,Anyang District Hospital,Puyang,Henan 455000,China;不详)

机构地区：[1]濮阳市安阳地区医院MRI室,河南濮阳455000 [2]新乡医学院第二附属医院影像科,河南新乡453002 [3]郑州大学第一附属医院影像科,河南郑州450001

出　　处：《中华全科医学》2024年第5期795-799,共5页Chinese Journal of General Practice

基　　金：河南省自然科学基金项目(222300420562)。

摘　　要：目的采用三维动脉自旋标记技术(3D-ASL)评估脑梗死患者脑白质血流灌注状况,采用蒙特利尔认知评估量表(MoCA)评估患者认知功能,分析脑白质血流灌注情况与认知功能之间的关系。方法收集2020年3月—2023年3月期间濮阳市安阳地区医院收治的123例脑梗死患者的临床资料,采用MRI 3D-ASL检测各脑白质区脑血流量(CBF)。根据患者出院后3个月是否发生认知功能障碍(CD)分为对照组(74例)及CD组(49例)。采用logistic回归分析模型明确脑梗死CD发生的影响因素,Pearson相关性分析研究脑梗死患者脑白质区CBF值与MoCA评分的相关性,ROC曲线分析脑白质区CBF值对脑梗死患者CD发生的预测效能。结果123例患者中CD发生率为39.84%(49/123);CD组MoCA评分低于对照组(P<0.05)。Logistic回归分析显示,高水平Hcy及额叶、顶叶及枕叶白质区的低水平CBF值是脑梗死患者发生CD的独立危险因素(P<0.05);Pearson相关性分析结果显示,患者额叶、顶叶及枕叶CBF值与MoCA评分均呈正相关关系(P<0.05);ROC曲线分析结果显示,额叶、顶叶及枕叶CBF值及三者联合预测脑梗死患者发生CD的AUC分别为0.542、0.634、0.633、0.793,三者联合的预测效能高于单独检测(P<0.05)。结论脑梗死CD患者存在脑白质血流灌注异常,额叶、顶叶及枕叶CBF值与MoCA评分呈正相关关系,三者联合对脑梗死后CD的发生具有较高的预测价值。Objective Three-dimensional arterial spin labeling(3D-ASL)is used to assess the white matter blood perfusion status of cerebral infarction patients,the Montreal cognitive assessment(MoCA)is used to assess the cognitive function of patients,and the relationship between white matter blood perfusion status and cognitive function is analyzed.Methods Clinical data of 123 patients with cerebral infarction admitted to Anyang Regional Hospital in Puyang City from March 2020 to March 2023 were collected,and cerebral blood flow(CBF)in each white matter region was detected by MRI 3D-ASL.Patients were divided into control group(74 cases)and cognitive dysfunction(CD)group(49 cases)according to whether CD occurred 3 months after discharge.Logistic regression analysis model was used to determine the factors affecting the occurrence of cerebral infarction CD.Pearson correlation was used to analyze the correlation between white matter CBF and MoCA score in patients with cerebral infarction.Receiver operating characteristic curve(ROC)was used to analyze the predictive effect of CBF in white matter region on CD occurrence in patients with cerebral infarction.Results Among the 123 patients,the incidence of CD was 39.84%(49/123),and the MoCA score of CD group was lower than that of control group(P<0.05).Logistic regression analysis showed that high level of Hcy and low level of CBF in frontal,parietal and occipital white matter areas were independent risk factors for the occurrence of cerebral infarction CD(P<0.05).Pearson correlation analysis showed that CBF values in frontal,parietal and occipital lobes were positively correlated with MoCA scores(P<0.05).ROC analysis results showed that the CBF value of frontal,parietal and occipital lobes and the AUC of the CBF value combined with the CBF value of the three lobes were 0.542,0.634,0.633 and 0.793,respectively,and the predictive efficiency of the CBF value combined with the CBF value of the three lobes was higher than that of the single detection(P<0.05).Conclusion There is abnormal

关 键 词：脑梗死 三维动脉自旋标记技术 脑白质 血流灌注异常 认知功能 相关性 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]