血管性痴呆的脑白质异常信号MR临床分析

MR clinical analysis of white matter hyperintensity in patients with vascular dementia

目的:对血管性痴呆患者MR图像上的脑白质异常信号(WMH)进行体积定量测量的临床分析,并与无痴呆的脑血管病患者进行比较。方法:对18例临床诊断为血管性痴呆的患者和15例脑血管病对照患者间隔一年先后进行两次头颅MRI检查。采用自行设计的自动体积测量软件测量每位患者的初始WMH体积以及随访结束时的WMH体积变化,然后采用独立样本t检验对血管性痴呆组和对照组的初始WMH体积和WMH体积变化进行比较。结果:血管性痴呆组初始WMH体积为28269±28124mm3,WMH体积变化为4374±4242mm3。对照组的初始WMH体积为11865±10052mm3,WMH体积变化为1913±2574mm3。两组之间的初始WMH体积差异具有统计学意义(t=2.304,P=0.031),而WMH体积变化则表现出有统计学意义差异的趋势(t=1.963,P=0.059)。结论:血管性痴呆患者比普通的脑血管病患者存在更加严重的白质病变,并且进展加快。WMH的增加可能认知功能的下降有关。

Objective：To assess white matter hyperinteasity （WMtt） quantitatively in patients with vascular dementia witl serial cra- nial MRI, and compare it with the WMtt in stroke patients Mthout dementia. Methods： Eighteen pmients with vascular dementia （VD group） and 15 stroke patients without dementia （control group） were examined with a 1.5T MR seamier at tbe initial and follow-up during an interval of more than one year. The hnaging data was processed with a software to quantify the volume of WMH and WIVItt change automatically for each subject. Independent sample test was used to compare the volume of WMH and WMH change between tile VD group and control group.Results：Tile initial vohane of WMH was 28269 ± 28124 mm^3 for VD group and it was 11865 ± 10052 mm3 for control group. The volume change of WMH was 4374 ± 4242 mm3 for VD group and 1913 ± 2574 into3 for control group. Tilere is significant dif- ference of initial WMI{ volume between the VD group and control group （ t = 2.304, P = 0.031）. The difference of volumetric WMH change between the two groups showed some statistical tendency （ t = 1. 963, P = 0. 059）. Conclusion：Patients with vascular dementia have more severe wtfite matter lesions relative to those stroke patients without dementia, arid WMIt may progress more rapidly in their brains. The progression of WMH may be related to the cognitive decline in patients with cerebrovascular disease.