阿尔茨海默病和血管性痴呆的颅脑核磁共振定量研究

A quantitative measurement of MR volumes in Alzheimer's disease and vascular dementia

目的测量阿尔茨海默病(AD)、血管性痴呆(VD)患者颅脑MRI片上的海马结构(HF)、胼胝体(CC)、侧脑室(LV)、外侧裂(SL)、白质疏松(LA)体积,建立判别函数,进行判别分析,提高区分AD组、VD组与老年健康对照组(NC)间的准确性。方法应用GESigna1.5T超导磁共振成像系统,对AD组、VD组、NC组各20例进行颅脑扫描,根据体视学的卡瓦列里原理,构建测试网格,对HF、CC、LV、SL、LA体积进行测量,建立判别函数,进行判别分析。结果AD组、VD组HF、CC体积均显著小于NC组,LV、SL、LA体积显著大于NC组;AD组的HF、LA体积均显著小于VD组。Fisher判别函数示判别总符合率为83.3%,AD组为95%,VD组为75%,NC组为80%。结论测量颅脑MRI的HF、CC、LV、SL、LA体积,建立判别函数,对AD、VD患者的临床诊断及鉴别诊断可能有一定的指导意义。

Objective To quantitatively measure hippocampal formation （HF）, corpus callosum （CC）, lateral ventricles （LV）, sulcus lateralis （SL） and leukoaraiosis （LA） of the patients with Alzheimer＇s disease （AD） and vascular dementia （VD） and construct Fisher＇s linear discriminant functions with these indicators to improve the accuracy of differentiating AD, VD and normal control （NC）. Methods All scans were performed on a 1.5T MR scanner （GE Signa）. We made test griddings based on the Cavalieri＇s theory of stereology to quantitatively measure HF, CC, LV, SL and LA of the patients with AD （n=20） and VD （n=20） and of the controls （n=20） and construct Fisher＇s linear discriminant functions with these indicators. Results Volumes of HF and CC were significantly reduced in the patients with AD and VD. Volumes of LV, SL and LA were significantly larger in the patients with AD and VD than those in the controls. Volume of HF and LA in AD group was smaller than that in VD group. Fisher＇s linear discriminant functions indicated that total discriminant analysis rate was 83.3% （AD group 95%, VD group 75%, NC group 80%）. Conclusion The quantitative measurements of HF, CC, LV, SL, LA and the construction of Fisher＇s linear discriminant functions would help the differentiation of AD, VD and NC.