特发性正常压力脑积水患者头颅MRI定量参数与认知功能、精神状态的相关性分析

Correlation Analysis of Quantitative Parameters of Skull MRI with Cognitive Function and Mental State in Patients with Idiopathic Normal Pressure Hydrocephalus

目的:探究特发性正常压力脑积水(iNPH)患者头颅磁共振成像(MRI)定量参数与认知功能、精神状态的相关性。方法:以2017年1月—2023年1月贵溪市人民医院与南昌大学第二附属医院收治的iNPH患者86例为iNPH组,同期在以上医院进行健康体检的人群中选取50例作为对照组。全部研究对象均接受头颅MRI检查,并比较iNPH组和对照组的Evan’s指数、胼胝体夹角、灰质比、白质比。采用简易精神状态检查(MMSE)评估精神状态,采用蒙特利尔认知评估量表(MoCA)评估认知功能,探究MRI定量参数与精神状态、认知功能的相关性。结果:iNPH组的Evan’s指数、灰质比均显著高于对照组,胼胝体夹角、白质比均低于对照组,差异均有统计学意义(P<0.05);重度认知功能障碍组与轻度认知功能障碍组患者的Evan’s指数及胼胝体夹角比较,差异均无统计学意义(P>0.05);重度认知功能障碍组患者的灰质比显著高于轻度认知功能障碍组,白质比低于轻度认知功能障碍组,差异均有统计学意义(P<0.05);logistic回归分析显示,灰质比、白质比与iNPH患者的认知功能及精神状态无相关性(P>0.05)。结论:iNPH患者的MRI定量参数与健康人群存在显著差异,灰质比、白质比在认知功能、精神状态评估中有一定价值,但灰质比、白质比与认知功能、精神状态并无相关性。

Objective:To explore the correlation between quantitative parameters of skull magnetic resonance imaging(MRI)and cognitive function,mental state in patients with idiopathic normal pressure hydrocephalus(iNPH).Method:A total of 86 iNPH patients admitted to Guixi People's Hospital and the Second Affiliated Hospital of Nanchang University from January 2017 to January 2023 were selected as the iNPH group,and 50 patients who underwent physical examination in the above hospitals during the same period were selected as the control group.All research subjects underwent skull MRI examination,and Evan's index,corpus callosum included angle,gray matter ratio and white matter ratio of iNPH group and control group were compared.Mental status was assessed by mini mental status examination(MMSE),cognitive function was assessed by Montreal cognitive assessment(MoCA).The correlation between MRI quantitative parameters and mental state and cognitive function were explored.Result:Evan's index and gray matter ratio in iNPH group were significantly higher than those in control group,and corpus callosum included angle and white matter ratio were lower than those in control group,the differences were statistically significant(P<0.05).There were no significant differences in Evan's index and corpus callosum included angle between the severe cognitive dysfunction group and the mild cognitive dysfunction group(P>0.05).The gray matter ratio in the severe cognitive dysfunction group was significantly higher than that in the mild cognitive dysfunction group,and the white matter ratio in the severe cognitive dysfunction group was lower than that in the mild cognitive impairment group,the differences were statistically significant(P<0.05).logistic regression analysis showed that gray matter ratio and white matter ratio had no correlation with cognitive function and mental state of iNPH patients(P>0.05).Conclusion:MRI quantitative parameters of iNPH patients were significantly different from those of healthy people.Gray matter ratio and white matter ratio had certain value in the assessment of cognitive function and mental state,but gray matter ratio and white matter ratio had no correlation with cognitive function and mental state.