机构地区:[1]上海交通大学医学院附属仁济医院放射科,上海200127
出 处:《上海医学》2024年第11期683-691,共9页Shanghai Medical Journal
基 金:国家自然科学基金(82171885);上海市科学技术委员会科技计划项目(21TS1400700);上海市卫生健康委员会人才计划(2022LJ023)。
摘 要:目的利用沿血管周围间隙的扩散张量成像分析(DTI-ALPS)方法评价脑小血管病(CSVD)患者的类淋巴系统功能,并探究CSVD患者类淋巴系统功能与认知功能之间的关系。方法回顾性地纳入2016年6月—2021年8月在上海交通大学医学院附属仁济医院神经内科门诊就诊的152例CSVD患者(CSVD组),另选取40名健康志愿者作为对照组。对39例CSVD患者进行了随访复查。CSVD组在MRI扫描后1周内接受一系列标准化的认知功能评估测试,包括简易智力状态检查量表(MMSE)、连线测试(TMT)-A和B、Stroop色词测验(SCWT)、Rey-Osterrich复杂图形测验(RCFT)、听觉词语学习测验(AVLT),并记录量表评分。对照组在MRI扫描后1周内接受MMSE测试,并记录量表评分。两组均使用开源的FMRIB软件库中扩散工具箱计算左、右侧大脑半球及全脑总DTI-ALPS指数(L-ALPS、R-ALPS及T-ALPS)。比较两组间DTI-ALPS指数。CSVD组DTI-ALPS指数与各认知量表评分的相关性采用Pearson偏相关分析,并采用多元线性回归分析筛选与各认知量表评分独立相关的变量。CSVD组随访前后DTI-ALPS指数变化率与MMSE评分变化率的相关性采用Pearson偏相关分析。结果CSVD组与对照组的年龄、性别构成、受教育年限的差异均无统计学意义(P值均>0.05)。CVSD组的MMSE评分为(26.87±3.61)分,显著低于对照组的(28.63±1.37)分(P=0.012)。控制年龄和性别的影响后,CSVD组的L-ALPS、R-ALPS及T-ALPS指数均显著低于对照组(P值均<0.001)。CSVD组的R-ALPS指数显著低于同组L-ALPS指数(P<0.01)。控制人口学资料(年龄、性别、受教育年限)和CVSD风险因素(糖尿病、高血压、冠心病、高三酰甘油血症、高胆固醇血症、吸烟、酗酒)的影响后,DTI-ALPS指数与MMSE评分(r=0.199,P=0.033)、AVLT-4评分(r=0.209,P=0.012)、AVLT-5评分(r=0.168,P=0.036)、RCFT评分(r=0.228,P=0.012)呈显著正相关,DTI-ALPS指数与TMT-A评分(r=-0.303,P=0.001)、TMT-B评分(r=-0.191,P=0.0Objective To evaluate the glymphatic system function in patients with cerebral small vessel disease(CSVD)using diffusion tensor imaging analysis along the perivascular space(DTI-ALPS),and to explore the relationship between glymphatic system function and cognitive function in CSVD patients.Methods A total of 152 CSVD patients who visited the Department of Neurology of Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2016 to August 2021 were retrospectively analyzed,and 39 of them were followed up and assigned to CSVD group.Forty healthy volunteers were selected as control.The patients in the CSVD group underwent a series of standardized cognitive assessments within 1 week after MRI scan,including mini-mental state examination(MMSE),trail making test(TMT)-A and B,Stroop color and word test(SCWT),Rey-Osterrich complex figure test(RCFT),and auditory verbal learning test(AVLT).The healthy volunteers underwent MMSE within 1 week after MRI scan.The DTI-ALPS index of the whole brain,left and right cerebral hemisphere(T-ALPS,L-ALPS,and R-ALPS)were calculated by the open-source diffusion tool box in the FMRIB software library.Pearson partial correlation was used to analyze the association between DTI-ALPS indexes and cognitive scores of the scales in CSVD group,and multiple linear regression was used to select the variables independently associated with cognitive scores.Pearson partial correlation was used to analyze the association between the variation of DTI-ALPS index and the variation of MMSE score in CSVD patients before and after follow-up.Results There was no significant difference in age,gender composition,or education years between the two groups(all P>0.05).The MMSE score in the CVSD group was significantly lower than that in the control group(26.87±3.61 vs 28.63±1.37,P=0.012).After adjustment of age and gender,L-ALPS,R-ALPS,and T-ALPS indexes in the CSVD group were significantly lower than those in the control group(all P<0.001).R-ALPS index was significantly lower than
关 键 词:沿血管周围间隙的扩散张量成像分析 脑小血管疾病 胶质淋巴系统
分 类 号:R445.2[医药卫生—影像医学与核医学]
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