早期阶段Alzheimer病内颞叶记忆系统多相关结构多变量的定量MRI研究

A quantitative MRI analysis of multivariable of correlative multistructure of the medial temporal lobe memory system in the early stages of Alzheimer disease

目的定量评价内颞叶记忆系统多相关结构（包括海马结构、杏仁核、侧脑室颞角）与多变量（包括体积、Ｔ２弛豫时间）区分早期阶段Ａｌｚｈｅｉｍｅｒ病（Ａｌｚｈｅｉｍｅｒｄｉｓｅａｓｅ，ＡＤ）组与健康对照组的准确性，为早期阶段ＡＤＭＲＩ研究提供确定准确、简便的结构与变量的依据。方法使用Ｓｉｅｍｅｎｓ１．５Ｔ超导ＭＲＩ扫描机，对２３例临床诊断的早期阶段ＡＤ病人与２９例健康对照组的不同侧别［左侧、右侧及（左侧＋右侧）／２），后者简称均侧］海马结构、杏仁核及侧脑室颞角体积以及海马结构、杏仁核Ｔ２弛豫时间进行定量测量，对不同相关结构不同变量及其组合进行统计学处理。结果海马结构、杏仁核、侧脑室颞角体积及海马结构、杏仁核Ｔ２弛豫时间在早期阶段ＡＤ组与健康对照组之间存在着显著性差异（Ｐ＜０．０１），均侧海马结构、杏仁核及侧脑室颞角体积定量测量区分早期阶段ＡＤ与健康对照组准确性分别为８８．５％、７９．３％、９０．４％，海马结构、杏仁核Ｔ２弛豫时间定量测量区分早期阶段ＡＤ组与健康对照组准确性均为９４．２％。内颞叶记忆系统多相关结构多变量判别分析结果表明，海马结构、杏仁核、侧脑室颞角体积及海马结构Ｔ２弛豫时间能够使区分早期阶段ＡＤ组与健康?

Purpose To evaluate the accuracy of volume measurements of multivariable of correlative multistructure of the medial temporal memory system including hippocampal formation (HF), amygdala(AM), and temporal horn(TH) of lateral ventricle and the accuracy of T 2 relaxation time measurements of HF and AM in the early stage of Alzheimer disease (AD) as distinguished from age matched healthy control subjects. Methods Volume measurements of the HF,AM, TH, normalized by total intracranial volume were obtained on oblique coronal sections (1.5T,repetition time /echo time 500 / 15ms, slice 2mm) and measurements of the T 2 relaxation time of the HF,AM were obtained on oblique coronal sections (1.5T, repetition time/echo time, echo time 3000/90,60 ms, slice 5mm ) of 23 patients in the early stages of AD (MMSE≥21) and 29 age matched healthy control subjects. Results Both the volume of HF,AM, TH and the T 2 relaxation time of HF and AM showed significant differences between the patients in the early stages of AD and the control subjects ( P <0.01). The accuracy of volume of HF,AM, TH to differentiate the patients in the early stages of AD from control subjects was 88.5%, 79.3%, 90.4% respectively, and the accuracy of T 2 relaxation time of HF,AM was 94.2%,94.2% respectively, the accuracy of both T 2 relaxation time of HF and T 2 relaxation time of AM was still 94.2%. But the multivariable of correlative multistructure could make the accuracy close to 100%, stepwise discriminant analysis revealed that the volume of HF,TH,and T 2 relaxation time of HF together could also make the accuracy close to 100%. Conclusion Neither univariable such as volume or T 2 relaxation time nor correlative unistructure suchas HF or AM or TH can distinguish the patients in the early stages of AD from the control subjects completely, measurementsof multivariable of correlative multistructure can make the accuracy close to 100%. The volume of HF,TH and T 2 relaxation time of HF measurements together can replace the multivariable of correlative multistructure of the medial temporal lobe memory system to differentiate the patients in the early stages of AD from the control subjects.