三维伪连续动脉自旋标记技术用于遗忘型轻度认知功能障碍患者随访

目的 采用三维伪连续动脉自旋标记（3D PCASL）技术随访遗忘型轻度认知功能障碍（aMCI）患者脑血流量（CBF）变化，并分析其与认知功能的相关性。方法 对15例aMCI患者进行3D PCASL序列MR扫描，首诊及随访时各扫描1次，同时进行简易智能状态检查量表（MMSE）及蒙特利尔认知评估量表（MoCA）评分；随访时间7~13个月，平均（10.77±1.84）个月。采用SPM 8软件，以基于体素法分析随诊前后CBF图，获得随访前后CBF值有差异的脑区，评价CBF值差值与MMSE、MoCA评分差值的相关性。结果 aMCI患者随访前后MMSE和MoCA评分差异均无统计学意义（P均>0.05）。与首次扫描比较，随访时aMCI患者左侧颞中回和左侧颞下回CBF值下降（P均<0.001）。随访前后左侧颞中回和左侧颞下回平均CBF差值与MMSE及MoCA评分差值无明显相关（P均>0.05）。结论 随病情进展，采用3D PCASL技术可检测aMCI患者左侧颞中回和左侧颞下回的CBF值下降，且较临床神经心理量表更加敏感，应用前景良好。

3D pseudo-continuous arterial spin labeling in follow-up of patients with amnestic mild cognitive impairment

Objective To follow up the changes of cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (aMCI) using 3D pseudo-continuous arterial spin labeling (PCASL), and to analyze the correlation with cognitive function. Methods Totally 15 patients with aMCI were recruited and scanned with 3D PCASL sequence at the first time and following-up. And the mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were measured twice as well. The follow-up interval ranged from 7 to 13 months, with average (10.77±1.84) months. SPM 8 software was used to analyze the CBF maps before and after follow-up based on voxel. The brain regions with different CBF values before and after follow-up were obtained. Correlations between changes of CBF values and changes of MMSE scores, MoCA scores were calculated. Results There were no significant difference of MMSE scores nor MoCA scores between the first time and the follow-up in patients with aMCI (both P>0.05). Compared to the first time examination, significant decreases of CBF values were found in the left middle temporal gyrus and left inferior temporal gyrus in follow-up examination (both P<0.001). The differences of CBF values between the first time and follow-up in the left middle temporal gyrus and left inferior temporal gyrus had no correlation with the differences of MMSE nor MoCA scores (all P>0.05). Conclusion With the progress of the disease, 3D PCASL can detect the decrease of CBF values in left middle temporal gyrus and left inferior temporal gyrus in patients with aMCI, more sensitive than clinical neuropsychological scale. 3D PCASL has good application prospect in the follow-up of aMCI patients.