MRI线性测量对阿尔茨海默病与血管性痴呆的鉴别诊断价值

目的：探讨MRI线性测量对阿尔茨海默病(AD)与血管性痴呆(VD)患者的鉴别诊断价值。方法根据ICD-10诊断标准，选取自贡市精神卫生中心2014年5月至2016年1月临床确诊为AD和VD的患者各50例，观察和测量所有患者的海马高度、颞角宽度、外侧裂宽度、第3脑室宽度、额角指数及尾状核指数6个参数值。结果 AD组患者的海马平均高度为9.47 mm，颞角宽度平均高度为5.03 mm，外侧裂平均宽度为4.51 mm，第3脑室平均宽度6.56 mm；VD组患者的海马平均高度为13.01 mm,颞角宽度平均高度为2.96 mm，外侧裂平均宽度为3.09 mm，第3脑室平均宽度为5.73 mm，AD组与VD组患者的上述各项指标比较差异均具有统计学意义(P<0.05)；AD组患者的额角平均指数和尾状核平均指数分别为34.76和15.32，VD组分别为33.99和14.59，两组患者比较差异均无统计学意义(P>0.05)。结论阿尔茨海默病与血管性痴呆患者的鉴别诊断依据主要是靠临床症状联合影像学检查，MRI能作为辅助诊断，应用海马高度、颞角宽度测量鉴别诊断价值较高。

Differential diagnosis value of magnetic resonance imaging linear measurement on patients with Alzheimer's ;disease and vascular dementia

Objective To explore the differential diagnosis value of magnetic resonance imaging (MRI) linear measurement on patients with Alzheimer's disease (AD) and vascular dementia (VD). Methods According to the diag-nostic criteria of ICD-10, totally 50 patients with Alzheimer's disease (AD group) and 50 patients with vascular demen-tia (VD group) in Zigong Mental Health Center from January 2016 to May 2014 were selected. The hippocampal height, width of temporal horn, lateral fissure width, the third ventricle width, six parameters of frontal horn index and caudate nucleus index value of all patients were observated and measured. Results The average height of the hippocampus, the average height of the temporal horn width, the average width of the lateral fissure, and the average width of the third ven-tricle of patients in AD group were 9.47 mm, 5.03 mm, 4.51 mm, 6.56 mm, respectively. In VD group of patients, the av-erage height of the hippocampus, the average height of the temporal horn width, the average width of the lateral fissure, and the average width of the third ventricle were 13.01 mm, 2.96 mm, 3.09 mm, 5.73 mm, respectively, with statistically significant difference between the two groups (P<0.05). The forehead average index and the caudate nucleus average in-dex were 34.76 and 15.32 in AD group, 33.99 and 14.59 in VD group, respectively. There were no significant differences between two groups of patients (P>0.05). Conclusion Differential diagnosis of Alzheimer's disease and vascular de-mentia is mainly based on the clinical symptoms combined with imaging examination. MRI can be used as an auxiliary diagnosis, and the diagnosis value was higher for hippocampal height and temporal horn width measurement.