阿尔茨海默病脑CT灌注与认知功能的相关性研究

Study on correlation between CT brain-perfusion and cognitive function in patients with Alzheimer's disease

目的:探讨阿尔茨海默病(AD)脑CT灌注与认知功能的相关性,评估CT灌注在AD病情评估中的应用价值。方法:根据临床诊断标准,51例AD采用飞利浦16排螺旋CT进行头颅平扫后再进行灌注扫描,随后在GEADW4.4工作站上作后处理,并进行灌注参数测量,灌注参数包括脑血容量(cerebral blood volume,CBV)、脑血流量(cerebral blood flow,CBF)、平均通过时间(mean transit time,MTT)和达峰时间(time to peak,TTP)。选择双侧颞叶皮质、双侧海马、双侧额叶皮质、双侧基底节豆状核区域进行测量,采用SPSS13.0统计软件进行统计分析,并将结果与简易智力状态检查(MMSE)评分行相关性分析。结果:单因素方差分析得出TTP与MMSE呈显著负相关(左额叶皮质P=0.031,左颞叶皮质P=0.008,右颞叶皮质P=0.024,左基底节P=0.009,右基底节P=0.019,右海马P=0.032,左海马P=0.009)。结论:脑CT灌注参数TTP与临床认知功能相结合对评估AD临床进展程度有一定帮助。

Objective To study the correlation between CT brain-perfusion and cognitive function,and to evaluate the use of CT brain-perfusion in the estimating and differential diagnosis of Alzheimer＇s disease（AD）.Methods Fifty-one AD patients were enrolled and underwent brain perfusion imaging by multi-slices spiral computed tomography.CT brain-perfusion images were analyzed using a perfusion software and the parameters analyzed included cerebral blood volume（CBV）,cerebral blood flow（CBF）,mean transit time（MTT） and time to peak（TTP）.Bilateral temporal lobe cortex,bilateral hippocampus,bilateral frontal lobe cortex and bilateral basal ganglion area were measured,and its correlation with scores of mini-mental state examination（MMSE） was analyzed.SPSS13.0 software was used for statistical analysis.Results Univariate analysis showed that in patients with AD,TTP was negatively correlated with the scores of MMSE（left frontal lobe P=0.031,left temporal lobe P=0.008,right temporal lobe P= 0.024,left basal ganglion P=0.009,right basal ganglion P=0.019,right hippocampus P=0.032,left hippocampus P= 0.009）.Conclusions TTP in combination with clinical cognitive function is helpful for estimating the clinical progression of Alzheimer＇s disease.