多模态MRI参数及PWI定量参数对脑梗死患者并发认知功能障碍的预测价值分析  

Predictive value of multimodal MRI parameters and PWI quantitative parameters for cognitive dysfunction in patients with cerebral infarction

作　　者：李鹏[1] 张进[1] 徐新华[1] 刘俊[1] LI Peng;ZHANG Jin;XU Xin-hua;LIU Jun(Changzhou Cancer Hospital,Changzhou Jiangsu 213000,China)

机构地区：[1]常州市肿瘤医院,江苏常州213000

出　　处：《中国临床医学影像杂志》2024年第11期761-765,共5页Journal of China Clinic Medical Imaging

基　　金：江苏省卫生健康委员会2022年度医学科研立项项目(面上项目)(编号:M2022051)。

摘　　要：目的:分析多模态MRI参数及灌注加权成像(PWI)定量参数对脑梗死(CI)患者并发认知功能障碍的预测价值。方法:2020年5月—2023年8月将我院收治的139例CI并发认知功能障碍患者作为认知功能障碍1组,70例CI并发认知功能障碍患者作为认知功能障碍2组,同期收治的148例单纯CI患者作为非认知功能障碍1组,75例单纯CI患者作为非认知功能障碍2组,其中认知功能障碍1组和非认知功能障碍1组联合作为建模组,认知功能障碍2组和非认知功能障碍2组联合作为验证组。统计4组一般资料、多模态MRI参数及PWI定量参数,分析CI患者并发认知功能障碍的影响因素,并构建相关的预测模型,分析预测模型对CI患者并发认知功能障碍的预测价值及多模态MRI参数及PWI定量参数对CI患者并发认知功能障碍的预测价值。结果:年龄及脑白质病变(WML)评分、相对平均通过时间(rMTT)、相对达峰时间(rTTP)较高均为CI并发认知功能障碍的独立危险因素(OR=2.044、1.669、1.480、1.626,P<0.05),进一步进行模型构建得出相关的预测模型,模型区分度ROC曲线显示,该模型在建模组和验证组中的曲线下面积(AUC)分别为0.878和0.781。WML评分、rMTT、rTTP联合预测CI患者并发认知功能障碍的AUC均高于三者单独检测(P<0.05)。结论:CI患者并发认知功能障碍的影响因素主要为年龄、WML评分、rMTT、rTTP,其中WML评分、rMTT、r TTP联合可有效提高对CI患者并发认知功能障碍的预测价值。Objective:To analyze the predictive value of multimodal MRI and perfusion weighted imaging(PWI)for cognitive dysfunction in patients with cerebral infarction(CI).Methods:From May 2020 to August 2023,139 patients with CI complicated with cognitive dysfunction were treated in Changzhou Cancer Hospital as the cognitive dysfunction group 1,70 patients with CI complicated with cognitive dysfunction as the cognitive dysfunction group 2,148 patients with simple CI treated in the same period as the non-cognitive dysfunction group 1 and 75 patients with simple CI as the non-cognitive dysfunction group 2,in which cognitive dysfunction group 1 and non-cognitive dysfunction group I were combined as the modeling group,and the cognitive dysfunction group 2 and the non-cognitive dysfunction group 2 were combined as the verification group.The general data,multimodal MRI parameters and PWI quantitative parameters of the four groups were statistically analyzed.The influencing factors of cognitive impairment in CI patients were analyzed,and the relevant prediction models were constructed.The predictive value of the prediction model for cognitive impairment in CI patients and the predictive value of multimodal MRI parameters and PWI quantitative parameters for cognitive impairment in CI patients were analyzed.Results:Age,white matter lesion(WML)score,relative mean transit time(rMTT),and relative time to peak(rTTP)were all independent risk factors for CI complicated with cognitive dysfunction(OR=2.044,1.669,1.480,1.626,P<0.05).The model was further constructed to obtain the relevant prediction model.The ROC curve of the model discrimination showed that the area under the curve(AUC)of the model in the modeling group and the verification group was 0.878 and 0.781,respectively.The AUC of combined WML score,rMTT and rTTP in predicting cognitive impairment in CI patients was higher than that of the three alone(P<0.05).Conclusion:Age,score of WML,rMTT and rTTP are the main influencing factors of cognitive dysfunction in patients with CI.Th

关 键 词：脑梗死 认知功能障碍 磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]