皮质下缺血性血管性痴呆患者的弥散张量改变

Diffusion tensor changes in patients with subcortical ischemic vascular dementia

目的应用弥散张量成像技术探讨皮质下缺血性血管性痴呆(subcortical ischemic vascular dementia,SIVD)患者脑白质弥散张量变化的特点。方法对45例SIVD患者和45例年龄匹配的正常非痴呆对照者,测量感兴趣区各向异性分数(fractional anisotropy,FA)值和表观弥散系数(apparent diffusion coefficient,ADC)值,比较其脑白质的弥散张量改变。结果在SIVD患者中左额叶前部皮质下白质的FA值小于右侧,而ADC值大于右侧。与对照组比较,SIVD患者在双侧额叶前部皮质下白质、侧脑室前后角区白质和胼胝体膝部弥散张量改变。双侧额叶前部皮质下白质的FA值与MMSE评分正相关。结论不同脑区的FA、ADC等弥散张量参数变化特点可能为SIVD患者的诊断提供依据。

Objective To investigate the abnormality of white matter using diffusion tensor imaging（DTI） in subcortical ischemic vascular dementia（SIVD）.Methods A region of interest-based DTI approach was applied to measure the fractional anisotropy（FA） and apparent diffusion coefficient（ADC） of white matter between 45 patients with SIVD and 45 age-matched nondemented controls.Results In SIVD group,FA value of left frontal subcortical white matter was lower than right side,while left side ADC value was greater than the right.Compared with control group,patients with SIVD showed diffusion tensor change in the bilateral frontal subcortical,anterior and posterior periventricular（PV） areas and genu of the corpus callosum.The FA value of bilateral frontal subcortical white matter was positively associated with the MMSE scores.Conclusion The changes of FA and ADC parameters in different brain regions may contribute to the diagnosis of SIVD.