Alzheimer病MRI诊断测量研究

Quantitative Study of MR Imaging to Diagnose Alzheimer's Disease

目的 评价ＭＲ 测量脑结构诊断Ａｌｚｈｅｉｍｅｒ 病（ＡＤ） 的价值。方法 对１２ 名可能的ＡＤ 患者（ 年龄６５３３ ±８６２） 和３６ 名年龄与性别匹配的正常人（ 年龄６５８１ ±７３７） 进行ＭＲＩ扫描。应用１０Ｔ ＭＲ 扫描仪（Ｓｉｅｍｅｎｓ Ｍａｇｎｅｔｏｍ Ｉｍｐａｃｔ） ，选大脑的８ 个感兴趣区域共１６ 个指标（ 分左右） 进行测量研究。结果 ①１６ 项指标在区分ＡＤ和正常对照时，灵敏度最高的指标依次为侧脑室颞角、海马旁回（ 旁回） 、海马及颞叶。②联合应用右颞叶、右海马和右旁回等脑实质指标判别ＡＤ的效果最佳（ 灵敏度为７５０ ％ ，特异度为１００ ％ ） ，而在脑沟室指标中，以颞角最佳。③联合应用右颞角、右颞叶、右海马和右旁回４ 项指标，区分ＡＤ 和正常对照的灵敏度为８３３ ％ ，特异度为９７２ ％ ，准确度达９３７５ ％ ；联合应用左侧相应指标具有同样效果。④若颞角扩大明显，ＡＤ的可能性很大；正常人不会同时出现颞叶、海马及旁回的萎缩。结论 应用ＭＲＩ多指标测量ＡＤ患者脑结构，可鉴别ＡＤ与正常人。

Purpose To evaluate the value of the brain structure measurement or MR imaging in diagnosis of Alzheimer's disease(AD).Methods Twelve patients with probable AD (age 65.33±8.62) and 36 age and gender matched normal controls (age 65.81±7.37) were studied,and 1.0T MR scanner (Siemens Magnetom Impact) was used.Eight indices altogether 16 regions (left and right) were measured and studied.Results ①When each of 16 indices was used to differentiate AD patients from controls respectively,the order of structures with high sensitivity is temporal horn,parahippocampal gyrus,hippocampus and temporal lobe.②As to the brain matter indices,right temporal lobe,right hippocampus,right parahippocampal gyrus used together had the best effective in differentiating AD patients from controls (sensitivity was 75.0%,specificity was 100%);however for the sulcus and ventricle structures,temporal horn is best.③The sensitivity,specificity and accuracy of right temporal horn,right temporal lobe,right hippocampus,right parahippocampal gyrus together in differentiating AD patients from normal controls came up to 83.3%(10/12),97.2%(35/36),and 93.75% respectively;and the corresponding structures of left side had the same effects.④Using brain matter structures and temporal horn we had a tentative criterion:if the temporal horn becomes greatly wide,the patient is most probably suffered from AD;and if hippocampus,parahippocampal gyrus,temporal lobe don't atrophy simultaneously,it is definitely a normal control.Conclusion Multi indices measurement of MRI can differentiate AD patients from normal controls. [