轻度阿尔茨海默病患者磁共振成像及磁共振氢质子波谱研究

The study of mild Alzheimer Disease by MRI and 1H-magnetic resonance spectroscopy

目的 探讨磁共振成像 (magneticresonanceimaging,MR)及磁共振氢质子波谱 (1H magneticresonancespectroscopy ,1H MRS)对轻度阿尔茨海默病 (Alzheimerdisease ,AD)患者的早期诊断。方法 对 18例临床确诊轻度AD患者和 2 0名正常对照者的MR及1H MRS进行分析 :MR上观察两组的海马回钩间距 (AB)及同层颅腔左右径 (CD)并计算两者间 (AB/CD)的比值 ;对两组额、颞叶区行1H MRS检测 ,得到N 乙酰天门冬氨酸 (N acetylaspartate ,NAA)峰、肌酸 (creatine ,Cr)峰、胆碱 (choline ,Cho)峰的积分值及计算NAA/Cr、NAA/ (Cr +Cho)。对 2组检测值 ( x±s)行t检验。结果 AD组的AB =(2 7 5 3± 2 1)mm ,AB/CD =(0 2 2± 0 0 5 )mm及额、颞叶的NAA分别是 32 74± 4 72和35 38± 3 5 2 ,颞叶的NAA/Cr=2 4 6± 0 4 3,与正常对照组比较均有统计学差异 (P <0 0 5 )。用ROC法找出诊断阈值并联合应用诊断早期AD ,敏感性为 87% ,特异性为 94 %。结论 海马回钩间距及其与同层颅腔左右径比值的增大 ;额、颞叶NAA的减少 ,尤其是颞叶NAA的减少有助于对轻度AD患者的早期诊断。

Objective To explore the early imaging signs of mild Alzheimer disease (AD) by MRI and? 1?H MRS. Methods 18 patients with clinically proved mild Alzheimer disease (AD) and 20 healthy volunteers were analysis by MRI and? 1?H MRS: The distance between both hippocampi gyri uncus (AB) and Left Right distance of cranial cavity (CD) were measured on the same MR scans and their ratio (AB/CD) was calculated. The integral perks of N acetyl aspartate(NAA), creatine(Cr), choline(Cho)and NAA/Cr、NAA/(Cr+Cho) were acquired from frontal and temporal lobes in both groups. All results were showed by mean±SD, and the data and integral perks were compared with t test between the two groups. Results AB=27 53±2 1,AB/CD=0 22±0 05, the integral perk of NAA in the frontal lobe was 32 74±4 72, and in the temporal lobe was 35 38±3 52, and NAA/Cr=2 46±0 43 in AD group. The difference was significant between the two groups ( P <0 05). The sensitivity of the method of ROC to find out the threshold of the above items to make early diagnosis of AD was 87% and the specificity was 94%. Conclusions It is helpful to make early diagnosis for mild AD if the distance between AB and CD, and their ratio (AB/CD) increase, and the integral perks of NAA decrease in the both lobes (especially in the temporal lobe).