神经影像学在血管性认知障碍诊断中的应用

血管性认知障碍（vascular cognitive impairment，VCI）是脑血管病危险因素（如高血压、糖尿病、高脂血症）以及明显的脑血管病（如脑梗死、脑出血）或不明显的脑血管病（如脑白质疏松、慢性脑缺血）引起的从轻度认知损害到痴呆的认知谱系疾病。VCI 早期的临床体征和症状通常不足以支持最终诊断，也不能鉴别病因，而神经影像学可以显示缺血性和出血性损伤灰质和白质损害，在VCI 的诊断和治疗中十分重要，同时也可以探索血管性认知障碍的病理生理机制。该文综述了计算机断层扫描（computed tomography，CT）、高分辨率核磁共振成像（high resolution magnetic resonance imaging，HRMRI）、弥散张量成像（diffusion tensor imaging，DTI）、磁共振波谱（magnetic resonance imaging spectroscopy，MRS）、动态增强核磁（dynamic contrast-enhanced MRI，DCEMRI）、依赖血氧水平的功能磁共振（blood oxygen level dependent functional magnetic resonance imaging，BOLD-fMRI）等影像学方法在VCI 诊断中的运用。

Value of Neuroimaging in Vascular Cognitive Impairment

Vascular cognitive impairment （VCI） is a cognitive spectrum disease，caused by risk factors of cerebrovascular diseases （hypertension，diabetes，hyperlipidemia），and obvious cerebrovascular diseases （such as cerebral infarction，cerebral hemorrhage） or less obvious cerebrovascular diseases （such as loose white matter，chronic cerebral ischemia）. It encompasses the full range of cognitive defcits from mild cognitive impairment to dementia. Since clinical signs and symptoms are often neither sufficient to allow for a final diagnosis，nor differentiate among the various etiologies，however neuroimaging can display the visualization of ischemic and hemorrhagic injury of gray and white matter，which not only plays an important role in the diagnosis of patients with impaired cognition，but also explore the pathophysiology of VCI. This review summarizes the application of neuroimaging methods in VCI diagnosis nowdays，including computed tomography （CT），high resolution magnetic resonance imaging（HRMRI），diffusiontensor imaging （DTI），magnetic resonance imaging spectroscopy （MRS），and dynamic contrastenhanced MRI （DCEMRI） and blood oxygen level dependent functional magnetic resonance imaging （BOLD-fMRI）.