腔隙性脑梗死认知功能损害患者头颅MRI特征

Cranial MRI characteristics of the patients with lacunar infarction cognitive impairment

目的探讨腔隙性脑梗死认知功能障碍(LICI)患者的头颅MRI特征。方法选取符合入组标准的腔隙性脑梗死患者31例和与之性别、年龄匹配的正常对照20例。按照临床表现及简易精神状态量表(MMSE)评分将腔隙性脑梗死患者分为腔隙性脑梗死认知功能障碍组(LICI组)、腔隙性脑梗死非认知功能障碍组(非LICI组),分析3组间头颅MRI影像学差异。结果与非LICI患者比较,LICI患者的病灶数目更多,病灶体积明显增大(P<0.05);病灶位于侧脑室旁白质、丘脑、额叶及左侧的腔隙性脑梗死患者更易发生认知功能障碍(P<0.05)。LICI组哈氏值较其他2组明显增大,前角指数较对照组明显减小。LICI组脑白质疏松程度0级的患者明显少于对照组(P<0.05);LICI组脑白质疏松程度为4级的患者明显多于对照组及非LICI组(P<0.05)。结论腔隙性脑梗死病灶数目、体积、部位都会对认知功能产生影响;脑萎缩及脑白质疏松的存在会加重患者的认知功能障碍。

Objective To investigate the cranial MRI features of the patients with lacunar infarction cognitive impairment(LICI). Methods Thirty-one patients suffering from lacunar infarction and 20 healthy controls were enrolled in this study. According to the clinical manifestations and MMSE scores, the patients with lacunar infarction were divided into LICI group and non-LICI group, and the cranial MRI images were analyzed. Results Compared with non-LICI group, the number and the size of lesions in LICI group were significantly increased(P<0.05).The patients with lesions at the lateral ventricle narration quality, thalamus, frontal lobe and the left side were more likely to suffer from cognitive dysfunction(P<0.05);The Harrington value of LICI group was significantly higher than that of the other two groups, and the anterior horn index of LICI group was significantly lower than that of the control group(P<0.05).There were fewer cases with 0 level leuckaraiosis in the LICI group than control group (P< 0.05),and there were more cases with 4 level leuckaraiosis in the LICI group than the control group and non-LICI group(P< 0.05). Conclusions The number, size and location of lacunar infarct lesion will have an impact on cognitive function; Brain atrophy and the presence of leukoaraiosis in patients with lacunar infarction would increase cognitive dysfunction.