不同严重程度脑白质疏松患者认知功能变化的脑白质弥散张量成像研究  

Changes in cognitive function in patients with different severities of leukoaraiosis by using diffusion tensor imaging

作　　者：赫娟[1] 巴图尔·吐尔地[1] 王辉[1] He Juan;Batur Turdi;Wang Hui(Center of Radiology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830019,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐830019

出　　处：《中华老年心脑血管病杂志》2025年第4期417-421,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：新疆维吾尔自治区自然科学基金(2024D01C79)。

摘　　要：目的分析不同严重程度脑白质疏松患者认知功能变化的脑白质弥散张量成像(diffusion tensor imaging,DTI)。方法选取2022年6月至2024年6月新疆维吾尔自治区人民医院神经内科纳入的脑白质疏松患者104例,根据Fazekas视觉等级评定标准分为轻度组31例、中度组46例、重度组27例,收集各组一般资料,采用简易智能状态检查量表(mini-mental state examination,MMSE)及蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评估各组患者认知功能,基于DTI检查获取各组患者不同感兴趣区各向异性(fractional anisotropy,FA)值,分析其与认知功能的相关性。结果3组性别、吸烟饮酒史、高血压、糖尿病、冠心病比例比较,无统计学差异(P>0.05);重度组年龄明显高于轻度组、中度组,差异有统计学意义[(78.49±7.05)岁vs(70.33±6.22)岁、(70.30±6.37)岁,P<0.05]。3组语言功能力、记忆力、回忆力、MMSE总分、MoCA评分比较,差异有统计学意义(P<0.01)。轻度组与中度组语言功能力、记忆力、回忆力、MMSE总分、MoCA评分明显高于重度组,差异有统计学意义(P<0.05)。轻度组、中度组、重度组顶叶FA值、胼胝体FA值依次降低,差异有统计学意义(P<0.01),且重度组患者额叶、颞叶、枕叶、侧脑室前角FA值明显低于轻度组和中度组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,语言功能力、记忆力、回忆力、MMSE总分及MoCA评分与额叶、颞叶、枕叶、侧脑室前角FA值呈正相关(P<0.05,P<0.01)。结论脑白质疏松患者病情严重程度越严重,认知功能越差,认为FA值与认知功能损害程度相关,主要导致语言功能力、记忆力、回忆力障碍,临床可通过DTI分析感兴趣区FA值用于评估认知功能。Objective To analyze the changes in cognitive function in patients with different severities of leukoaraiosis using diffusion tensor imaging(DTI).Methods A total of 104 patients with leukoaraiosis admitted to our hospital from June 2022 to June 2024 were enrolled,and then according to Fazekas visual assessment,they were divided into mild(31 cases),moderate(46 cases),and severe(27 cases)groups.Their general information was collected,and the cognitive function was evaluated using mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA).The fractional anisotropy(FA)values of different regions of interest were obtained by DTI,and their correlation with cognitive function was analyzed in each group.Results There were no significant differences in gender,smoking and drinking history,and proportions of hypertension,diabetes and coronary heart disease among the three groups(P>0.05).The severe group had more advanced age than the mild group and the moderate group(78.49±7.05 years vs 70.33±6.22 years and 70.30±6.37,P<0.05).Statistical differences were observed among the three groups in terms of scores of language,memory and recall,total score of MMSE and MoCA scores(P<0.01).The mild group and the moderate group had obviously higher scores of language,memory,calculation and recall,total score of MMSE,and MoCA scores than the severe group(P<0.05).The FA values of the parietal lobe and the corpus callosum were decreased in the mild,moderate and severe groups in order(P<0.01),and the FA values of the frontal lobe,temporal lobe,occipital lobe and anterior horn of the lateral ventricle in the severe group were notably lower than those in the mild group and the moderate group(P<0.05).Pearson correlation analysis showed that the scores of language,memory and recall,total MMSE score and MoCA scores were positively correlated with FA values of the frontal lobe,temporal lobe,occipital lobe and anterior horn of the lateral ventricle(P<0.05,P<0.01).Conclusion For patients with leukoaraiosis,the more severe the cond

关 键 词：病人病情 脑白质疏松症 认知功能障碍 弥散张量成像 各向异性 磁共振成像 

分 类 号：R74[医药卫生—神经病学与精神病学]