MRI线性测量与体积测量在Alzheimer病诊断中的比较研究  

Comparative MR analysis of linear and volumetric measurements in diagnosing Alzheimer disease

作　　者：王蕊[1] 李坤成[1] 刘树良[1] 

机构地区：[1]首都医科大学宣武医院放射科

出　　处：《中华放射学杂志》2003年第5期389-393,共5页Chinese Journal of Radiology

基　　金：北京市科学技术委员会资助项目 ( 95 1890 6 0 0 )

摘　　要：目的　比较内颞叶结构的MRI线性测量与体积测量鉴别阿尔茨海默病 (Alzheimerdisease ,AD)患者与正常者的能力 ,同时为AD的临床诊断寻找简单实用的影像学测量指标。方法研究对象包括 32例临床诊断可能为AD的患者和 32例健康老年人。对双侧海马、侧脑室颞角、海马旁回及内嗅皮层进行线性测量和体积测量 ,并对体积指标进行标准化处理 ,应用判别分析方法获得各线性指标和体积指标诊断AD的敏感度、特异度及准确度。结果　各线性指标经多元逐步判别分析 ,右侧侧脑室颞角高度和右侧内嗅皮层厚度进入判别方程 ,其特异度为 96 9%,敏感度为 84 4%,准确度为 90 6 %;对各标准化体积指标进行多元逐步判别分析 ,左侧内嗅皮层和左侧海马进入判别方程 ,其特异度为 10 0 0 %,敏感度为 90 6 %,准确度为 95 3%。AD患者所有的线性及体积测量指标值与正常对照者间差异均有显著性意义 (t =- 6 80～ 12 5 3,P <0 0 5 ) ;经检验 ,线性测量与体积测量的Kappa值为 0 779(t=6 2 3,P <0 0 1)。结论　内颞叶结构的MRI线性测量与体积测量对AD的鉴别均具有较高的敏感度和特异度 ;线性测量简单易行 ,适于临床推广应用。Objective To compare the discriminative ability of MRI linear measurements and volumetric measurements between patients with Alzheimer disease (AD) and control subjects, and to evaluate their clinical value. Methods The study group consisted of 32 patients with probable Alzheimer disease and 32 healthy control subjects. Linear measurements and volumetric measurements of the bilateral hippocampal formations, temporal horns of lateral ventricle, parahippocampal gyri, and entorhinal cortices were performed on the serial reconstructed MR images. Discriminant analysis was used to identify measurements independently contributing to discriminating between AD and control subjects. Results With a stepwise method, the right height of temporal horn and right thickness of entorhinal cortex of linear measurements entered the function. The specificity, sensitivity, and accuracy of this function were 96.9%, 84.4%, and 90.6%, respectively. The left entorhinal cortex and left hippocampus of volumetric measurements entered the other discriminant function. The specificity, sensitivity, and accuracy of the second function were 100.0%, 90.6%, and 95.3%, respectively. All the linear and volumetric measurements of cerebral regions were significantly different between AD group and control subjects(t= -6.80～12.53,P<0.05). With Kappa test, Kappa value was 0.779(t=6.23,P<0.01). Conclusion All the MRI volumetric and linear measurements of medial temporal lobe structures have high sensitivity, specificity, and accuracy in the discriminative power between AD patients and control subjects. In clinical practice, linear measurements may be more feasible because the method is easier to use.

关 键 词：阿尔茨海默病 颞叶结构 磁共振成像检查 线性测量 体积测量 

分 类 号：R445.2[医药卫生—影像医学与核医学]