摘要
目的 探讨质子磁共振波谱(1H-MRS)对Alzheimer病(AD)和血管性痴呆(vaD)的诊断和鉴别诊断的作用。方法 采用点解析波谱法(PRESS),对24例AD患者、16例VaD患者和24例年龄匹配健康对照的双侧颞顶叶灰质区1H-MRS进行分析,比较各组间N-乙酰天门冬氨酸/肌酸(NAA/Cr)和胆碱/肌酸(Cho/Cr)比值的差别,并对AD和VaD组的简易智能精神状态量表(MMSE)评分与NAA/Cr、Cho/Cr进行相关分析。 结果 AD组和VaD组的NAA/Cr显著低于对照组(P<0.05),AD组的NAA/Cr显著低于VaD组(P<0.05),三组间的Cho/Cr无差异。AD组的MMSE评分与NAA/Cr明显正相关(P<0.05),与Cho/Cr无关。VaD组的MMSE评分与NAA/Cr、Cho/Cr均无关。结论 AD和VaD患者的双侧颞顶叶灰质区NAA/Cr比值的降低和AD患者NAA/Cr的变化与痴呆严重程度的相关性,对AD和VaD的诊断和鉴别诊断有一定参考作用。1H-MRS对AD的疾病监测也有重要作用。
Objective To evaluate the roles of proton magnetic resonance spectroscopy(1H-MRS)in the diagnosis and the differential diagnosis of Alzheimer disease (AD) and vascular dementia (VaD). Methods A 1H-MRS was performed in the bilateral temporoparietal grey matters of 24 AD patients 、16 VaD patients and 24 healthy age-matched controls with use of point resolved spectroscopy (PRESS). The ratios of NAA/Cr and Cho/Cr were compared among the groups. Correlation coefficients were calculated for Mini Mental State Examination (MMSE) scores and the ratios of NAA/Cr and Cho/Cr in the AD group and the VaD group. Results In comparison with the controlled group, both the AD group and the VaD group showed a significant reduction of NAA/Cr ratio (P<0.05), the AD group showed a significant reduction in the NAA/Cr ratio compared with the NAA/Cr ratio from the VaD group (P<0.05), the Cho/Cr ratios in the three groups showed no significant differences. The AD group showed a significant correlation between MMSE and NAA/Cr(P<0.05), and a non-significant association with Cho/ Cr. The VaD group did not show a significant correlation between MMSE and NAA/Cr and Cho/Cr. Conclusion The reduction of NAA/Cr ratio in patients with AD and VaD in the bilateral temporoparietal grey matters and the chang of NAA/Cr ratio in patients with AD show correlation to its severity, which seems to be able used for the diagnosis and the differential diagnosis of AD and VaD. 1H-MRS alse has an important effect on AD progression.
出处
《上海医学影像》
2004年第2期91-93,106,共4页
Shanghai Medical Imaging
