磁敏感加权成像与血管性认知障碍的相关性研究

目的探究磁敏感加权成像(SWI)对脑微出血(CMBs)的诊断价值及其与血管性认知障碍的关系。方法选择2017年2月至2018年12月于我院神经内科行SWI检查的68例CMB患者纳入CMBs组,另择70例同期行SWI未见异常的查体者作为对照组。所有受试者均行磁共振T1WI、T2WI、弥散加权成像(DWI)、液体衰减反转恢复(FLAIR)及SWI检查,采用蒙特利尔认知量表(MoCA)评价患者认知功能,比较两组受试者认知功能差异及不同CMBs数量、分布患者认知功能差异,并分析其相关性。结果CMBs在SWI扫描中呈现边界清楚的圆形信号缺失区;SWI对CMBs的检出率显著高于其他扫描序列(P<0.05);CMBs组患者MoCA量表各维度及总分均明显低于对照组(P<0.05);不同病情严重程度受试者比较,随病情严重程度增加,患者MoCA量表各维度及总分明显降低(P<0.05);Pearson相关性分析示,CMBs数量与MoCA量表中视空间执行能力、抽象能力、定向力、注意力、语言、记忆力及总分呈负相关(P<0.05);皮质及皮质下CMBs与注意力及总分呈负相关,基底核及丘脑CMBs与视空间执行能力、语言、注意力及总分呈负相关(P<0.05),脑干及幕下CMBs与视空间执行能力、总分呈负相关(P<0.05)。结论SWI可提高CMBs的检出率,CMBs患者可伴有认知功能的降低,其数量与病情严重程度相关,SWI检测CMBs数量及分布可作为评估认知功能障碍风险的参考指标。

Correlation between Susceptibility Weighted Imaging and Vascular Cognitive Impairment

Objective To explore the diagnostic value of susceptibility-weighted imaging(SWI) for cerebral microbleeds(CMBs) and its relationship with vascular cognitive impairment(VCI).Methods 68 CMB patients who underwent SWI in Neurology Department,our Hospital,from February 2017 to December 2018 were enrolled in the CMBs group.70 patients without abnormalities who underwent SWI in the same period were enrolled as a control group.All subjects underwent magnetic resonance T1 WI,T2 WI,diffusion-weighted imaging(DWI),fluid-attenuated inversion recovery(FLAIR),and SWI.The cognitive function was evaluated by Montreal Cognitive Assessment(MoCA).The differences in cognitive function between the two groups,and differences in cognitive function among patients with different numbers and distribution of CMBs were compared.Moreover,their correlations were analyzed.Results In the SWI scan,CMBs showed a round the region with a clear boundary and signal deletion.The detection rate of SWI for CMBs was significantly higher than that of the other scanning sequences(P<0.05).The scores in all dimensions and total score of MoCA in the CMBs group were significantly lower than those in the control group(P<0.05).Compared among subjects with different disease severity,scores in all dimensions and total score of MoCA were significantly decreased with aggravation of disease severity(P<0.05).Pearson correlation analysis showed that the number of CMBs was negatively correlated with visual space execution ability,abstract ability,orientation,attention,language,memory and total score in MoCA(P<0.05).Cortical and subcortical CMBs were negatively correlated with attention and total score.The basal ganglia and thalamus CMBs were negatively correlated with visual space execution ability,language,attention and the total score(P<0.05).Brainstem and subtentorial CMBs were negatively correlated with visual space execution ability and the total score(P<0.05).Conclusion SWI can improve the detection rate of CMBs.CMB patients may be accompanied by cognitive function reduction.The number of CWIs is related to disease severity.The number and distribution of CMBs detected by SWI can be applied as reference indexes for assessing the risk of cognitive dysfunction.