DTI成像参数与脑微出血者认知功能障碍的关系

目的 探究脑微出血（CMBs）患者弥散张量成像（DTI）检测参数与认知功能障碍间的相关性。方法 收集笔者医院神经内科98例脑微出血患者作为观察组，另选择在笔者医院检测未发现脑部微出血80例作为对照组，采用日常生活能力评定表（ADL）对日常生活进行评定，蒙特利尔认知评分表（MoCA）对受试者认知功能进行评估，所有受试者均能进行DTI成像检测，观察CMBs病灶数目以及分布情况，对比两组MoCA、ADL评分，DTI参数FA、MD值与MoCA评分进行Pearson相关性分析。结果 共检测出325例CMBs病灶，基底核区占44.31%，大脑皮质以及皮质占26.46%，丘脑占8.31%、脑白质占8.00%、小脑占6.77%、脑干占6.15%。观察组脑白质、丘脑、小脑FA值低于对照组，MD值高于对照组，差异有统计学意义（P<0.05）。观察组空间执行能力、命名能力、记忆力、注意力、抽象能力、语言、定向能力、总分均低于对照组，差异有统计学意义（P<0.05）。观察组ADL步行、转移、上下楼梯等各项评分以及总分均低于对照组，差异有统计学意义（P<0.05）。Pearson相关性分析显示，MoCA评分中空间执行能力、命名能力、记忆力、注意力、抽象能力、语言、定向能力、总分与基底核、脑皮质、脑白质、丘脑、小脑、脑干FA值呈正相关，与MD值呈负相关。结论 DTI检测FA值、MD值与CMBs患者MoCA评分存在一定的相关性，对患者认知功能障碍恢复具有一定的指导作用。

Relationship between DTI Imaging Parameters and Cognitive Impairment in Patients with Cerebral Hemorrhage

Objective To investigate the correlation between diffusion tensor imaging (DTI) parameters and cognitive impairment in patients with cerebral hemorrhage (CMBs). Methods Totally 98 patients with cerebral hemorrhage in the Department of neurology were collected as observation group.In addition, 80 cases of brain micro bleeding were detected in our hospital as the control group.Daily life ability scale (ADL) was used to assess daily life.The Montreal cognitive rating scale (MoCA) was used to assess the cognitive function of the subjects.All subjects were performed by DTI imaging test.The number and distribution of CMBs lesions were observed. The correlation of two groups of MoCA and ADL score, DTI parameter, FA, MD value and MoCA score were analyzed by Pearson. Results A total of 325 CMBs lesions were detected.The basal ganglia area was 44.31%,cerebral cortex and cortex was accounted for 26.46%,thalamus was 8.31%,white matter was 8%,cerebellum was 6.77%,and brainstem was 6.15%.The FA value of the white matter, thalamus and cerebellum in the observation group was lower than that in the control group, and the MD value was higher than that of the control group,and the difference was statistically significant (P<0.05).The spatial execution ability, naming ability, memory, attention, abstraction ability, language, orientation ability and total score of the observation group were lower than those of the control group, the difference was statistically significant (P<0.05).In observation group, ADL walking, transfer, up and down stairs and other scores and total score were lower than the control group, the difference was statistically significant (P<0.05).Pearson correlation analysis showed that the MoCA scores included spatial execution ability, naming ability, memory, attention, abstraction, language, orientation ability and total score was positively correlated with the FA of basal ganglia, cerebral cortex, white matter, thalamus, cerebellum and brainstem, and negatively correlated with MD. Conclusion DTI detection, FA value, MD value and CMBs score of patients with MoCA have some relevance, which can be used to guide the recovery of cognitive impairment.