磁敏感加权成像对脑微出血的检测及与认知功能障碍关系的研究

Role of susceptibility-weighted imaging in detection of cerebral microbleeds and its relation with cognitive impairment

目的探讨脑微出血(CMBs)在磁敏感加权成像序列(SWI)上的影像表现,分析CMBs不同部位及数量与认知功能障碍的相关性。方法对入选患者采用SWI技术检测有无CMBs,选取CMBs阳性(CMBs组)72例;另选CMBs阴性74例为对照组,经蒙特利尔认知评估量表(MoCA)及简易智能状态检查量表(MMSE)评价患者的认知功能情况,比较2组患者MoCA及MMSE测试结果及不同部位和数量的CMBs引起的认知功能障碍情况。结果 SWI对CMBs病灶的检出数量较常规MRI序列明显增多;CMBs组患者M0CA及MMSE总分、视空间与执行功能、命名、记忆、注意力、语言、抽象能力、定向力评分均明显低于对照组(P<0.01);CMBs多数位于大脑半球深部及颞叶:MoCA、MMSE测评认知功能的敏感性差异有统计学意义(P<0.01)。CMBs与认知功能损害有相关性(r=-0.51,P<0.01)。结论 SWI较常规MRI序列能更好地显示CMBs;CMBs及其不同部位与患者不同认知功能受损密切相关,MoCA对于认知功能的检测较MMSE更敏感。

Objective To study the cerebral microbleeds（CMBs） on susceptibility-weighted imaging（SWI） and analyze the correlation between CMBs at different sites and cognitive impairment. Methods CMBs was detected in 189 patients on SWI. The patients were divided into positive CMBs group（n--72） and negative CMBs group（n=74）. Their cognitive function was assessed according to the Montreal Cognitive Assessment（MoCA） Scale and the Mini Mental State Examination（MMSE） Scale, respectively. Cognitive impairments due to CMBs at different sites in two groups were compared. Results The number of CMBs lesions on SWI was significantly greater than that on MRI. The total score and the scores of visual space and executive function,nomenclature,memory,attention power,linguistics,abstract ability and orientation force of CMBs patients as shown on the MoCA and MMSE Scales were significantly lower in CMBs group than in control group（P〈0. 01）. CMBs was usually located in the basal ganglia and temporal lobe. The total score of cognitive function was higher on the MoCA Scale than on the MMSE Scale（P〈0.01）. CMBs is was found to be related with cognitive impairment（r= 0. 51, P〈0. 01）. Conclusion SWI is more sensilive than MRI to CMBs. CMBs sites are closely related with cognitive impairment in CMBs patients. MoCA Scale is more sensitive than MMSE Scale to cognitive function in CMBs patients.