磁共振三维动脉自旋标记成像在血管性认知障碍患者血流动力学和预后评估中的应用  

Application of three-dimensional magnetic resonance arterial spin labeling imaging in the evaluation of hemodynamics and prognosis in patients with vascular cognitive impairment

作　　者：范凌燕 邢国平[1] 吴晓丽[2] 于海宁[1] 郭国财 FAN Lingyan;XING Guoping;WU Xiaoli;YU Haining;GUO Guocai(Department of Neurology,Weifang People's Hospital,Weifang 261041,China;Department of radiology,Weifang People's Hospital,Weifang 261041,China;Department of Neurosurgery,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]山东省潍坊市人民医院神经内科,山东潍坊261041 [2]山东省潍坊市人民医院放射科,山东潍坊261041 [3]山东省潍坊市中医院神经外科,山东潍坊261041

出　　处：《医学影像学杂志》2024年第6期22-25,共4页Journal of Medical Imaging

基　　金：山东省潍坊市科技发展计划项目(编号:2022YX057)。

摘　　要：目的探讨磁共振三维动脉自旋标记成像在血管性认知障碍患者血流动力学和预后评估中的应用价值。方法选取缺血性脑小血管病60例患者的临床资料。使用MoCA量表认知功能评估并分为认知障碍组(30例)及认知正常为对照组(30例),采用不同PLD(1.5 s、2.5 s)行3D-ASL脑灌注成像,应用GE AW4.5工作站对双侧额叶、颞叶、顶叶、海马及颞顶交界处进行镜面对称测量(CBF_(1.5)、CBF_(2.5)),比较两组WMLs评分差异,分析WMLs评分/MoCA量表评分与各脑区CBF的相关性。结果认知障碍组WMLs评分明显高于对照组,差异有统计学意义(P<0.05)。与对照组相比,认知障碍组双侧额叶、颞叶、顶叶、海马及颞顶交界处的CBF_(1.5)值均明显较低,认知障碍组双侧额叶、颞叶与海马区的CBF_(2.5)值明显较低,差异有统计学意义(P<0.05)。对不同PLD下,认知障碍组患者的双侧额叶CBF_(1.5)与CBF_(2.5)值差异具有统计学意义(P<0.05)。双侧额叶CBF_(1.5)值/CBF_(2.5)值与WMLs评分呈显著负相关;双侧额叶、颞叶、海马CBF_(1.5)值及双侧额叶、海马、左侧颞叶CBF_(2.5)值与MoCA评分呈显著正相关(P<0.05)。结论3D-ASL技术中PLD=1.5 s指标下对识别VCI患者脑低灌注的敏感度较高,而PLD=2.5 s指标下特异度较高;WMLs与VCI严重程度呈正相关。Objective To investigate the application value of three-dimensional magnetic resonance arterial spin labeling imaging in the evaluation of hemodynamics and prognosis of patients with vascular cognitive impairment.Methods The clinical data of 60 patients with ischemic small cerebral vascular disease admitted were retrospectively analyzed.They were divided into cognitive impairment group(30 cases)and cognitive normal group(30 cases).MoCA scale was used to assess cognitive function.3D-ASL brain perfusion imaging was performed by different PLDS(1.5 and 2.5 s).The mirror symmetry measurement(CBF_(1.5) and CBF_(2.5))was performed on bilateral frontal lobe,temporal lobe,parietal lobe,hippocampus and temporoparietal junction using GE AW4.5 workstation.The differences of WMLs score between the two groups were compared,and the correlation between WMLs score/MoCA scale score and CBF in each brain area was analyzed.Results WMLs score in the cognitive impairment group was significantly higher than that in the cognitive normal group,and the difference was statistically significant(P<0.05).Compared with the cognitive normal group,the CBF_(1.5) values of the bilateral frontal lobe,temporal lobe,parietal lobe,hippocampus and temporoparietal junction were significantly lower in the cognitive impairment group,while the CBF_(2.5) values of the bilateral frontal lobe,temporal lobe and hippocampus were significantly lower in the cognitive impairment group,with statistical significance(P<0.05).Under different PLD,the difference of CBF_(1.5) and CBF_(2.5) values in bilateral frontal lobe of cognitive impairment group was statistically significant(P<0.05).CBF_(1.5) of bilateral frontal,temporal and hippocampal lobes and CBF_(2.5) of bilateral frontal,hippocampal and left temporal lobes were significantly positively correlated with MoCA scores.Conclusion In 3D-ASL technique,the sensitivity of detecting cerebral hypoperfusion in VCI patients is higher under PLD=1.5 s index,while,the specificity is higher under PLD=2.5 s index.WMLs is posit

关 键 词：磁共振三维动脉自旋标记成像 血管性认知障碍 血流动力学 脑白质损害 

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