认知量表在轻度认知障碍和阿尔茨海默病中的应用

阿尔茨海默病(Alzheimer disease,AD)及轻度认知功能障碍(mild cognitive impairment,MCI)是导致老年人记忆力障碍的重要原因.本研究应用认知量表对45例认知障碍患者进行评价,现报道如下..     

基于体素的遗忘型轻度认知障碍和轻度阿尔茨海默病全脑白质MR扩散张量成像分析

目的 采用基于体素的分析(VBA)方法研究遗忘型轻度认知障碍(aMCI)患者和轻度阿尔茨海默病(AD)患者全脑白质微观结构改变的特点及其与灰质萎缩模式的关系.方法 选取33例aMCI患者(aMCI组)、32例轻度AD患者(轻度AD组)和31名正常老年人(健康对照组),对全脑进行3.0 T DTI及三维快速扰相梯度反转回波(3DFSPGR)脉冲序列扫描.采用统计参数图(SPM)5软件对被试者的结构图像及各向异性(FA)图进行预处理,然后采用t检验对aMCI组、轻度AD组和正常对照组的全脑灰质体积及FA值进行基于体素的统计学比较,计算出有统计学意义的脑区.结果 与正常对照组比较,aMCI组的双侧额颞叶和左侧枕叶白质、左侧扣带前部、左侧顶下小叶、右侧脑室三角区外上方白质的FA值减低;轻度AD组的双侧额颞枕叶、海马旁白质、扣带前部、胼胝体、侧脑室三角区旁白质、顶下小叶、左侧颞于、左侧丘脑、右侧楔前叶FA值减低.基于体素的形态测量学(VBM),分析发现,aMCI患者组左侧海马、海马旁回、舌回、颞上回,双侧岛叶、颞中回出现了灰质萎缩;轻度AD患者组双侧海马、海马旁回、杏仁核、丘脑、额叶、颞叶、顶叶、枕叶皮质出现了灰质萎缩.aMCI与轻度AD患者组全脑白质FA值减低的模式与灰质萎缩模式不同.aMCI组与轻度AD组比较未发现具有统计学意义的FA值减低脑区.aMCI、轻度AD患者组全脑白质FA值与简易智能精神状态检查量表(MMSE)评分没有相关性.结论 基于体素的MR DTI全脑白质分析能够较全面、客观地揭示aMCI、轻度AD的脑白质损害的模式.aMCI、轻度AD患者白质损害的模式与灰质不同,提示脑白质病变是多种病理机制导致的.aMCI患者向轻度AD进展过程中,脑白质各向异性改变不显著,脑白质FA值的改变可能无法反映患者认知功能障碍的严重程度.

Abstract：

Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.     

基于体素的遗忘型轻度认知障碍和轻度阿尔茨海默病全脑白质MR扩散张量成像分析

Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.     

基于体素的遗忘型轻度认知障碍和轻度阿尔茨海默病全脑白质MR扩散张量成像分析

Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.     

酰胺质子转移磁共振成像在阿尔茨海默病和轻度认知障碍中的应用

目的 探讨3D酰胺质子转移(APT)磁共振成像诊断阿尔茨海默病(AD)和轻度认知障碍(MCI)的可行性。资料与方法 前瞻性收集2020年9月—2022年1月在北京医院接受治疗的AD患者29例、MCI患者19例和性别、年龄匹配的正常对照组20例进行头部3D APT磁共振成像,计算双侧额叶灰质和海马的3.5 ppm处酰胺质子不对称磁化转移率(MTR_asym),比较不同脑区3组间MTR_asym(3.5 ppm)的差异,对有差异的脑区进行两两比较(Bonferroni校正)。分析双侧额叶灰质和海马的MTR_asym(3.5 ppm)与简易精神状态量表(MMSE)评分的相关性。对组间有差异的APT参数进行受试者工作特征曲线分析,评估其对AD的诊断效能。结果 左侧额叶灰质MTR_asym(3.5 ppm)在3组间差异有统计学意义(F=4.18,P=0.02),右侧额叶灰质和双侧海马3组间MTR_asym(3.5 ppm)差异无统计学意义(F=1.37、0.49、0.50,P均>0.05),...     

阿尔茨海默病与轻度认知障碍患者初级嗅觉皮层的形态与功能改变

目的 确定阿尔茨海默病(AD)与轻度认知障碍(MCI)患者中初级嗅觉皮层的萎缩程度,并且探讨解剖学萎缩与嗅觉功能减低的内在联系.方法 选取12例AD、8例MCI患者和20名正常志愿者(NC),进行标准的嗅觉功能和神经学评分,而后进行高分辨率MRI和嗅觉fMRI.于T_1WI上确定初级嗅觉皮层的边界,并测量常规初级嗅觉皮层的容积,将此容积保存为ROI.然后采用事件相关的实验设计进行嗅觉fMRI,测量初级嗅觉皮层ROI内的激活体素.3组间的初级嗅觉皮层体积和激活范围比较采用Kruskal-Wallis秩和检验,如存在统计学差异则进行Bonferroni法两两比较.解剖学体积与激活范围情况的相关性在控制年龄因素下进行偏相关性分析.结果 NC、MCI和AD组初级嗅觉皮层的体积范围分别为3024～4734、1409～4553和1561～3759 mm~3,中位数分别为3749、2752和2156 mm~3;激活体素范围分别为0～2360、0～2160和0～100 mm~3,中位数分别为430、40和0 mm~3,NC、MCI和AD组初级嗅觉皮层体积和激活体素依次降低,差异有统计学意义(H值分别为14.942、16.587,P值均<0.05).初级嗅觉皮层内的激活与皮层体积的萎缩存在弱相关性(r=0.364,P=0.023).结论 AD初级嗅觉皮层存在明显萎缩与功能障碍,可以为AD的嗅觉功能障碍研究提供神经病理学和神经功能学依据.     

基于纤维束空间统计分析多参数DTI在遗忘型轻度认知障碍的应用

目的:采用基于纤维束空间统计分析(TBSS)的方法分析遗忘型轻度认知障碍(aMCI)患者DTI多参数图,以研究其全脑白质纤维束损害的特点以及可能的病理机制。方法:选取29例aMCI患者和30名正常老年人(正常对照组),对全脑进行1.5T磁共振DTI序列扫描。采用FSL软件对被试的DTI扫描数据进行预处理后对aMCI组、正常对照组的部分各向异性、平均弥散、轴向弥散、径向弥散图进行基于体素的全脑非参数统计学比较。结果:与正常对照组比较,aMCI组的双侧皮质脊髓束、双侧扣带束中部、双侧胼胝体、左侧内囊前肢、左侧外囊、双侧下额枕束、左侧上纵束、左侧膝状体内视路、右侧钩束、右侧视放射出现FA值减低;胼胝体膝部及体部、左侧皮质脊髓束、左侧内囊前后肢、左侧外囊、左侧上纵束出现MD值增加;DR值增高的区域与FA值类似;DA图未发现异常;左侧白质改变多于右侧。aMCI组全脑白质各参数图与简易智能精神状态检查量表(MMSE)评分没有相关性。结论:相对于正常老年人,aMCI患者脑内多发纤维束出现损害,其DTI多参数图改变特点提示白质纤维束的损害可能主要是由退行性改变(retrogenesis)导致的。DTI各参数图的改变可能无法反映患者总体认知功能障碍的严重程度,但这还需要进一步的大样本研究。     

基于体素的MRI形态分析诊断Alzheimer病的价值

目的评价基于体素的MRI形态分析（voxel-based Morphometry，VBM）法诊断Alzheimer病（AD）的价值。方法采用Siemens Sonata1．5T超导MR成像系统，对19例可能AD患者和15例年龄、性别与之相匹配的健康老年人及15例正常年轻人行全脑扫描，应用磁化准备快速梯度回波成像序列获取三维结构图像。数据分析采用以SPM99软件包为基础的全自动VBM技术进行处理。结果与健康老年对照组比较，AD患者两侧内颞叶（海马）明显萎缩（P〈0．001），右侧海马减少的体素总数为1529个，左侧海马减少的体素总数为1281个；而且AD患者右侧尾状核头和左侧内侧丘脑亦明显萎缩，减少的体素总数均为1529个；而感觉运动皮层、枕叶及小脑相对保持完好。此外，AD患者大脑皮层萎缩具有不对称性。结论VBM法操作简单，可自动化观察AD全脑萎缩情况，所得结论不仅与既往神经影像学研究结果一致，并得到了有重要价值的新发现，具有广阔的临床应用前景。     

阿尔茨海默病及轻度认知障碍PET/MR研究进展

阿尔茨海默病(AD)是一种进行性发展的神经退行性疾病,轻度认知障碍(MCI)被认为正常衰老和AD之间的过渡阶段。目前AD的治疗主要是延缓病情和预防并发症,因此早期诊断与干预尤为重要。新型大型影像设备PET/MR实现了对AD及MCI代谢、结构以及功能的多模态研究融合。本文就目前PET/MR在AD及MCI的研究现状做一综述。     

3T SWI小低信号病灶对轻度认知障碍和阿尔茨海默病的诊断

目的探讨基于3T磁敏感加权图像(SWI)对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者脑内微小低信号病灶(SHF)的发病率和分布图的分析,用于早期MCI的诊断及与AD的鉴别。方法对临床拟诊为MCI的病例36例和40例AD患者进行3T-SWI检查,并对所有患者进行简易精神状态检查表(MMSE)评分。2名高年资神经放射医师评价SWI相位图上SHF的数目和位置。部位包括脑叶(额颞顶枕叶)、基底节区/丘脑、脑干/小脑三个区域,并与MMSE评分进行统计相关分析。结果二组患者在年龄、性别及受教育程度方面无明显统计学差异(P值0.05)。SHF病灶以脑叶多见,其次基底节区/丘脑和脑干/丘脑。三类不同脑区的SHF的发病率在MCI和AD组间具有显著性差异(P值0.05)。MMSE的评分MCI为22±1.2,AD评分为18±1.5。且二组间MMSE存在统计学差异(P值0.05);3类不同区域间SHF发生率与MMSE呈负相关(r=-0.36,P0.05)。结论 3T-SWI成像技术简单,无创,安全可重复,易于检出异常SHF,可用于MCI的早期诊断和AD进展期的预测。     

基于体素的轻度阿尔茨海默病全脑灰质MRI成像分析

目的:利用磁共振T1 WI 3D成像研究轻度阿尔茨海默病患者相对于正常老年人灰质体积改变的特点.方法:对21例轻度AD患者及18例正常老年人进行三维T1WI扫描,利用基于SPM5的DARTEL工具箱对扫描获得的结构图像进行预处理,再对轻度AD组和对照组的令脑灰质体积进行基于体素的统计学比较.结果:轻度AD组的双侧海马、海马旁回及杏仁核、双侧丘脑、双侧颞枕叶皮质、双侧顶下小叶、双侧楔前叶、左侧中央后回、右侧额下回等结构与对照组的灰质密度差异具有统计学意义[P<0.05(FDR)].结论:基于体素的形态学研究能够发现轻度AD患者中大脑灰质广泛的及细微的结构萎缩,从而能够更加早期、全面、客观地反映轻度AD患者的脑结构改变.     

早期阿尔茨海默病脑白质改变和认知功能损伤的相关性

目的 探讨早期阿尔茨海默病(AD)脑白质变化与认知功能改变的关系.方法 对14例早期AD患者(AD组)和18名健康老年人(ON组)在1.5 T MR扫描仪上进行扩散张量成像(DTI)扫描.在9个感兴趣区测量并比较各向异性分数(FA)和平均扩散系数((-D)).对2组研究对象进行8个标准的神经心理测试,以评价其基本认知能力状态,并对测试结果 进行比较.分析所有研究对象DTI的FA和(-D)测量结果 与神经心理测试评分的相关性.结果 与ON组相比,AD患者在胼胝体压部(分别为0.25±0.03和0.49±0.03)和后顶-颞叶(分别为0.30±0.02和0.28±0.01)FA降低(t值分别为2.481、1.991,P值均＜0.05)、在胼胝体压部D提高(t=1.751,P＜0.05).在8个神经心理行为测试中,AD患者的评分均低于ON组(t值2.803～4.691,P值均＜0.05).相关性研究结果 显示,AD患者胼胝体压部和后顶-颞叶的FA与多个神经心理测试评分呈正相关(r值0.355～0.499,P值均＜0.05),而在较分散的多个部位(-D)与多个神经心理测试评分呈负相关(r值-0.518～-0.350,P值均＜0.05).结论 在AD早期阶段,患者不仅有认知功能的改变,而且还有白质结构的变化,两者存在一定的相关性,表现为脑白质的选择区域性损害,这种损害反映了AD病理机制中皮质间联系的丢失.     

海马体积测量联合 MMSE 评分在认知障碍中的应用

目的：探讨测量海马体积(HV)联合简易智力状况检查量表(MMSE)评分评估不同程度认知功能障碍的价值。方法收集阿尔茨海默病(AD)患者、轻度认知障碍(MCI)患者、正常对照(NC)各30例,应用西门子 MRI 行 HV 测量,综合分析3组患者标准化后的 HV、MMSE 评分。结果与 MCI、NC 组比较,AD 组总 HV、左右侧均减小,差别有统计学意义(P 值均<0.05);MCI 与 NC 2组之间 HV 无显著差异;分析3组患者的 MMSE 评分,AD 组分值均小于 MCI、NC 组,差别有统计学意义(P 值均<0.05),MMSE 评分在MCI 与 NC 2组间无差别。结论HV 测量联合 MMSE 评分,有助于为 AD 患者诊断提供有价值的信息,而在 MCI 中的诊断灵敏度不高。     

基于体素的形态测量学在震颤麻痹型多系统萎缩中的应用

目的 评价震颤麻痹型多系统萎缩(MSA-P型)患者全脑灰、白质体积减少区域及分布特征.方法 选取13例临床拟诊为MSA-P型可能性大的患者及14名年龄匹配的正常对照者行全脑三维快速扰相梯度回波(3D fast spoiled gradient echo,3D-FSPGR)序列扫描,采用基于体素的形态测量学(voxel-based morphometry,VBM)分析方法的统计参数图软件(statistical parametric mapping,SPM)8,对MSA-P型患者及正常对照者的灰、白质体素进行分析.结果 与正常对照者相比,MSA-P患者的脑灰、白质体积均减少;脑灰质减少区多数区域呈双侧对称分布:包括双侧辅助运动区、背侧后扣带皮层、额叶内侧回、颞上回、小脑半球皮层等;少数区域仅累及单侧,如右侧初级运动皮层、体感联合皮层及左侧下前扣带皮层等.脑白质区主要累及双侧额上回、楔前叶、额叶下,左侧颞上回、扣带回及右侧额眶回、颞叶下等.结论 VBM方法具有自动、全面的特点,能客观地反映MSA-P患者组全脑结构的差异.     

基于体素的形态测量学技术在视神经脊髓炎脑改变中的初步应用

目的 通过基于体素的形态测量学(VBM)技术研究视神经脊髓炎(NMO)患者的脑体积变化情况,初步从结构方面探讨NMO的脑损害模式.方法 对23例NMO患者和15名健康志愿者进行脑部3D快速扰相梯度回波(FSPGR)序列扫描.原始数据用统计参数图(SPM)5软件进行处理.采用t检验比较两组全脑体积的差别,应用Pearson相关分析评价全脑体积和年龄的相关性.结果 NMO组患者的全商灰质体积[(610.2±55.0)ml]明显小于健康对照组[(657.2±36.3)ml],差异有统计学意义(t=-2.915,P＜0.05).NMO患者的年龄[(40±9)岁]与脑灰质分数[(42.5±2.6)%]呈负相关(r=-0.673,P＜0.05).局部脑体积分析结果显示,与健康对照组相比,NMO灰质体积减少主要集中在左侧岛叶和双侧后扣带回,白质体积减少区主要位于左侧额叶和左侧顶叶皮层下白质.结论 VBM技术可以敏感地检测NMO的脑体积变化情况.NMO患者的脑体积较健康对照组有减少的趋势,以灰质萎缩更明显.

Abstract：

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.     

扩散张量成像在遗忘型轻度认知障碍和Alzheimer病中的应用

目的：探讨磁共振扩散张量成像（DTI）在遗忘型轻度认知障碍（AMCI）、Alzheimer病（AD）诊断中的作用。方法：对20名aMCI患者、20名AD患者、20名正常对照者（NC）行DTI检查,分别在颞叶白质、顶叶白质、海马、胼胝体膝部及压部、上纵束Ⅱ、扣带束测ROI的FA值和ADC值。结果：NC组与aMCI组、aMCI组与AD组比较扣带束FA值均有显著性差异（P〈0．05）;NC组与AD组比较颞叶、海马、胼胝体膝部、扣带束FA值,颞叶、海马ADC值有显著性差异（P〈0．05）。结论：aMCI患者扣带束FA值异常降低;AD患者颞叶、海马、胼胝体膝部、扣带束FA值降低和颞叶、海马ADC值增高,提示DTI检查有助于aMCI、AD患者的早期诊断。     

基于体素的形态测量学技术在视神经脊髓炎脑改变中的初步应用

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.     

基于体素的形态测量学技术在视神经脊髓炎脑改变中的初步应用

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.     

轻度认知障碍的功能性神经影像学研究进展

轻度认知障碍(MCI)是正常老化过程与早期阿尔茨海默病(AD)之间的一种中间过渡状态,具有进展为AD的高度危险性。功能性神经影像学手段(如PET、SPECT、fMRI脑显像)能对MCI脑代谢、血流灌注特点进行正确评价,有助于AD的早期诊断、病程监测、疗效观察及临床治疗个体的选择。     

基于体素的形态测量学在阿尔茨海默病研究中的应用

基于体素的形态测量学(voxel-based morphometry,VBM)是一种基于像素水平对脑MR图像进行自动、全面、客观分析的技术,可以同时对整脑定量检测脑组织成分的密度,是评价脑灰、白质病变的一种新方法.该技术面世10年来,已经被广泛的应用到各种病理条件下脑结构变化的研究中,加深了人们对很多中枢神经系统疾病脑损伤的认识.