阿尔茨海默病和轻度认知障碍磁共振动脉自旋标记脑灌注与神经心理学量表相关性研究

目的探讨阿尔茨海默病(alzheimer disease,AD)和轻度认知障碍(mild cognitive impairment,MCI)脑血流灌注改变、认知功能损害,以及二者之间的关系。材料与方法 30例经首都医科大学宣武医院神经内科记忆障碍门诊诊断的AD患者(AD组)、30例MCI患者(MCI组)、30例与之年龄、性别和受教育程度相匹配的正常老年人作为对照组(NC组)。采用2D连续性动脉自旋标记(arterial spin labeling,ASL)技术半定量测量局部脑血流和神经心理学量表联合评估AD患者脑灌注和认知状况,分析AD组、MCI组及NC组的认知状态、脑灌注特点,以及认知功能与脑灌注的相关性。结果 (1)3组被试年龄、性别、受教育年限比较,差异无统计学意义(P0.05),3组简易精神状态量表(mini-mental state examination,MMSE)评分、蒙特利尔认知评估量表(montreal cognitive assessment,Mo CA)评分两两比较差异均有统计学意义(P0.05)。(2)AD组和MCI组在双颞叶、双顶叶、双放射冠脑白质等信号强度不同程度降低,而且3组被试中两两比较差异均具有统计学意义。(3)对AD组、MCI组患者脑灌注多部位信号强度与MMSE及MOCA评分进行双因素相关分析发现,双颞叶、双顶叶信号强度与MMSE和Mo CA评分成正相关。结论 (1)应用ASL技术可以清晰显示AD患者和MCI的脑灌注减低区,与NC比较差异有统计学意义,可能有助于AD及MCI的早期评价。(2)MMSE和Mo CA评分与MRI的ASL脑灌注之间有良好的相关性,二者结合可提高判定AD和MCI的准确性。

A correlation study between the cerebral perfusion of arterial spin labeling of MRI and neuropsychological scale in patients with Alzheimer's disease and mild cognitive impairment

Objective: To investigate the changes of cerebral blood flow perfusion, cognitive function and the relationship between AD and MCI patients. Materials and Methods: Xuanwu Hospital of Capital Medical University neurology memory disorders clinic diagnosed 30 AD patients and 30 MCI patients and 30 cases with age, sex and level of education that match the normal old people as control group (NC group). Using 2D continuity ASL (arterial spin labeling) semi-quantitative measurement of local cerebral blood flow and neuropsychological scale joint assessment of cerebral perfusion in patients with AD and cognitive status. The cognitive state and the characteristics of cerebral perfusion of the three groups were analyzed, and the correlation between cognitive function and cerebral perfusion was analyzed also. Results: (1) The age, sex, years of education were compared in three groups of subjects, and the difference was not statistically significant (P>0.05). The differences of MMSE and MOCA scores had statistical significance in three groups(P<0.05). (2) The signal intensity of the bilateral temporal, parietal lobes and corona radiata of cerebral white matter in AD and MCI groups were reduced, the comparison of the three groups was statistically significant between the two-two groups. (3) The correlated analysis of the cerebral perfusion signal intensity and the MMSE and MOCA scores in AD and MCI patients, with two factors correlation analysis, found that the signal intensities of the bilateral temporal, and parietal lobes were positively correlated with MMSE and MoCA scores. Conclusion: (1) ASL provides an objective indicator for early diagnosis of AD and MCI in evaluating cerebral blood flow perfusion. (2)There was a good correlation between MMSE and MoCA scores and ASL cerebral perfusion of MRI, and the diagnostic accuracy of AD and MCI could be improved by the combination of the two examinations.