脑小血管病患者多模态影像学分析及与认知功能的相关性研究

目的：研究脑小血管患者功能性影像学特征并探讨其与患者认知功能损害的相关性。方法：脑小血管病患者15例作为观察组，健康受试者15名作为对照组，采用简易智力状况检查法（MMSE ）、蒙特利尔认知评估（Mo-CA）、美国国立卫生院神经功能缺损评分（NIHSS）评定患者认知功能损害程度；采用磁共振平扫及多模态磁共振成像技术观察平均弥散系数（ADC ）和各向异性值（FA ）以及脑内微出血数目与患者认知功能损害之间的关系。结果：观察组MMSE、MoCA评分明显低于对照组，而NIHSS评分高于对照组（均 P＜0．01）。观察组额颞叶、顶叶、基底节区FA值明显低于对照组（P＜0．05），ADC值明显高于对照组（P＜0．05）。观察组脑内微出血数目明显高于对照组（P＜0．01）。脑小血管患者脑内微出血数目及额颞叶 FA、DCaverage值与认知功能损害密切相关（P＜0．05）。结论：脑小血管病患者额颞叶白质损伤程度以及微出血数目与认知功能损害之间密切相关。

Relationship between functional features of multimode MR scan and cognitive impairment in patients with cerebral small vessel disease

Objective ：To investigate the relationship between functional features of multimode MR scan and cognitive impairment in patients with cerebral small vessel disease .Methods ：Fifteen cases of cerebral small vessel diseases and 15 healthy subjects were recruited as observation group and control group ,respectively .The cognitive impairment was evaluated using the mini-mental state examination （MMSE） ,Montreal cognitive assessment （MoCA） ,and National Institute of Health Stroke Scale （NIHSS） .The average diffusion coefficient （ADC） ,fractional anisotropy （FA） and cerebral micro bleeding were assessed using multimode MR scan .The relationship between small cerebral vessel disease and cognitive decline was also analyzed .Results ：The MMSE and MoCA scores were obviously lower , and NIHSS score was higher in observation group than in control group （P〈0 .01 for all） .The FA value in frontal temporal lobe ,parietal lobe and basal ganglia was obviously lower ,the ADC value and number of cerebral microbleeding were significantly higher in observation group than in control group （P〈0 .05 for all） .The number of cere-bral microbleedings ,the FA value and ADC value in frontal temporal lobe had a close relationship with the cognitive impairment （P〈0 .05） .Conclusion：The number of cerebral microbleedings and the severity of white matter damage were strongly associated with the cognitive decline .