男性痛风合并轻度认知功能障碍患者海马MR扩散张量成像的定量分析

目的 探讨海马区DTI在男性痛风合并轻度认知功能障碍(MCI)患者中的应用价值。方法 病例组纳入男性痛风患者35例,其中痛风合并MCI(gout-MCI)亚组15例,痛风合并认知功能正常(gout-CN)亚组20例,记录病例组患者最高血尿酸水平及近5年平均血尿酸水平。另选取15名健康志愿者作为正常对照组。对所有受检者行简明精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)评分后,行常规颅脑MR和DTI检查,测量并记录FA、ADC值,并进行统计学分析。结果 gout-MCI亚组患者近5年平均血尿酸水平低于gout-CN组患者(P<0.05)。gout-MCI亚组患者海马FA值低于gout-CN亚组及正常对照组(P<0.05),gout-MCI亚组患者海马ADC值高于gout-CN组及正常对照组(P<0.05)。gout-CN亚组患者海马FA值、ADC值与正常对照组差异无统计学意义(P>0.05)。gout-MCI亚组患者海马FA值与MoCA评分呈正相关(P<0.05),与MMSE评分无相关性,右侧海马ADC值与MoCA评分呈负相关(P=0.04)。结论 颅脑DTI技术可早期检测痛风合并MCI患者双侧海马的损伤。

Quantitative analysis of hippocampus diffusion tensor imaging in male gout patients with mild cognitive impairment

Objective To analyze the application value of hippocampus MR diffusion tensor imaging (DTI) in male gout patients with mild cognitive impairment (MCI). Methods Thirty-five male gout patients were enrolled, including 15 gout patients with mild cognitive impairment (gout-MCI subgroup) and 20 gout patients with cognition normal (gout-CN subgroup); both maximum and average values of serum uric acid concentration over the past 5 years were recorded. Fifteen healthy controls were recruited as control group. Conventional MRI and DTI were performed for all subjects following mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) evaluation. FA and ADC were measured on the work station. Statistical analysis was performed. Results The average value of serum uric acid concentration of gout-MCI subgroup was lower than that of gout-CN subgroup (P<0.05). The FA value in gout-MCI subgroup was lower than that in gout-CN subgroup and control group (P<0.05). The ADC value in gout-MCI subgroup was higher than that in gout-CN subgroup and control group (P<0.05). Both FA and ADC value in gout-CN subgroup had no statistical difference compared with those in control group. The FA value in gout-MCI subgroup had positive correlation with MoCA scores (P<0.05), had no correlation with MMSE scores (P<0.05). The ADC value of right hippocampus had negative correlation with MoCA score (P=0.04). Conclusion MR DTI can early detect mild impairment of hippocampus in gout patients with MCI.