MRI分析阿尔茨海默病进程中海马头、体、尾部体积改变

目的 探讨阿尔茨海默病（AD）进程中，海马头、体、尾部形态学改变。方法 对AD、轻度认知障碍（MCI）患者各30例（AD组、MCI组）及30名正常老年人（正常对照组）行颅脑MRI扫描。基于MRI扫描图像将海马头、体、尾部进行分段，并测量其体积。比较AD组、MCI组、正常对照组海马体积整体差异及头、体、尾部体积差异。分析海马体积与各神经评定量表评分的相关性。结果 3组中，左侧海马总体积及头、体、尾部体积均大于右侧（P均<0.05）。3组间左、右海马总体积比较，AD组小于正常对照组（P均<0.01）及MCI组（P均<0.05），MCI组小于正常对照组（P均<0.05）。与正常对照组比较，AD组左、右海马头、体、尾部体积均减小（P均<0.05），MCI组左海马头、体部及右海马头部体积减小（P均<0.05）。AD组左、右海马头、体部体积均小于MCI组（P均<0.05）。简易智能状态检查表（MMSE）评分与双侧海马头、体、尾部体积及总体积均呈正相关。除左海马尾部外，双侧海马头、体、尾部体积及总体积均与日常生活能力量表（ADL）评分及临床痴呆分级量表（CDR）评分呈负相关，均与蒙特利尔认知评估量表（MoCA）评分呈正相关。结论 AD患者双侧海马体积明显缩小，MCI患者海马体部、尾部萎缩不明显，但海马头部体积明显缩小。

MRI analysis of hippocampal head, body and tail volume changes in progresses of Alzheimer disease

Objective To investigate the morphological changes of the head, body and tail of the hippocampus in patients with Alzheimer''s disease (AD). Methods Totally 30 AD (AD group), 30 mild cognition impairment (MCI) patients (MCI group) and 30 normal old persons (normal control group) underwent brain MR scan. Based on the MR images, the head, body and tail of the hippocampus were segmented and the volume was measured. The difference of the volume in total, head, body and tail of hippocampus in AD group, MCI group and normal control group were compared. The correlation between hippocampal volume and the scores of neurological assessment scale was analyzed. Results The left total, head, body and tail volume were greater than those of the right side in 3 groups (all P<0.05). For the comparison of total volume of left and right sides among the 3 groups, AD group was less than normal control group (both P<0.01) and MCI group (both P<0.05), MCI group was less than normal control group (both P<0.05). Compared with the normal control group, the head, body and tail volume of hippocampus of both sides were decreased in AD group (all P<0.05) and the volume of left head, body and right head of hippocampus in MCI group were decreased (all P<0.05). Both sides hippocampus''s head and body volume of AD group were less than those of MCI group (both P<0.05). The scores of minimum mental state examination (MMSE) were positively correlated with the total and the head, body, tail volume of bilateral hippocampus. Except volume of left tail, there were negative correlations between the scores of activities of daily living (ADL), clinical dementia rating (CDR) and the volume of total and head, body, tail of bilateral hippocampus, which were positively correlated with Montreal cognitive assessment (MoCA) score. Conclusion The volume of bilateral hippocampus was significantly reduced in AD patients. The head of hippocampal volume was significantly reduced and the body and tail was not obvious.