阿尔茨海默病与血管性痴呆患者白质疏松的MRI定量研究

A quantitative study on the MRI of leukoaraiosis in patients with Alzheimer disease and vascular dementia

目的:探讨颅脑MRI白质疏松(leukoaraiosis,LA)与阿尔茨海默病(Alzheimerdisease,AD)患者、血管性痴呆(vasculardementia,VD)患者的关系,促进对AD和VD患者临床特点的认识。方法:AD,VD组各20例为解放军第一军医大学珠江医院收治患者,所有患者均符合简易智能量表(MMSE)标准,并排除其他可能引起痴呆的原因以及混合性痴呆,对照组20例为正常老年人。应用GESigna1.5T超导磁共振成像系统,对3组进行颅脑扫描,通过体视学知识对颅腔体积、LA体积进行测量,同时对LA程度进行记分,并对数据进行统计学处理。结果:各组颅腔体积差异无显著性意义(P=0.897);AD,VD组LA体积分别为(5.75±7.61),(10.00±8.12)cm3,均高于对照组(1.30±2.47)cm3,差异有非常显著性意义(F=8.735,P=0.000)。LA记分AD,VD组均显著高于对照组(P=0.001);VD组的LA体积、LA记分显著高于AD组(P=0.047)。结论:AD,VD患者的LA体积、严重程度较对照组显著增加;VD患者的LA体积、严重程度显著大于AD组患者,为两者的鉴别诊断提供了进一步的依据。

AIM:To investigate the relationship of cranial MRI leukoaraiosis(LA) with the severity of disease in patients with Alzheimer disease(AD) and vascular dementia(VD),and master the clinical features of AD and VD patients. METHODS:Totally 20 AD patients and 20 VD patients,who were in accordance with the standard of mini mental state examination(MMSE),were selected from the Zhujiang Hospital of First Military Medical University of Chinese PLA,and other reasons which could induce dementia and those with mixed dementia were excluded,and another 20 normal elderly people were taken as the controls.Craniocerebral scanning was performed with a GE Signa 1.5T superconduct MRI unit.Quantitative measurements were made with stereology, including encephalic volume(EV),LA volume and LA scores. RESULTS:There were insignificant differences of EV among the groups(P=0.897).The LA volume in the AD group[(5.75±7.61) cm3] and VD group[(10.00±8.12) cm3] were very significantly higher than that in the control group[(1.30±2.47) cm3](F=8.735,P=0.000).LA scores in AD group and VD group were significantly higher than that in the control group(P=0.001).LA volume and LA scores in the VD group were significantly higher than those in the AD group(P=0.047). CONCLUSION:LA volume and severity of AD and VD patients are significantly increased as compared with those in the control group,and those of VD patients are significantly greater than those of AD patients,which provides further evidence for the differentiation of AD and VE.