质子磁共振波谱诊断轻度认知障碍:Meta分析

Proton MR spectroscopy in diagnosis of mild cognitive impairment: A meta-analysis

目的用Meta分析的方法评价质子磁共振波谱(1 H-MRS)诊断轻度认知障碍(MCI)的价值。方法搜索Pubmed、CNKI、维普数据库相关文献。经异质性检验,采用不同效应模型对各ROI提取相关数据,获得汇总加权均数差(WMD)及95%可信区间(95%CI)。结果共纳入文献26篇(英文19篇,中文7篇)。病例组mI/Cr水平高于正常对照组,汇总WMD及95%CI为0.08(0.04,0.12),其中海马、扣带后回、颞叶、颞顶叶区差异有统计学意义;病例组NAA/Cr水平低于正常对照组,汇总WMD及95%CI为-0.07(-0.10,-0.04),仅海马区差异有统计学意义;两组Cho/Cr水平差异无统计学意义。结论海马区是MCI受累最早、最显著的部位。mI/Cr、NAA/Cr的变化能够反映MCI的病理生理过程,且mI/Cr的变化较NAA/Cr更为显著。

Objective To assess the value of proton magnetic resonance spectroscopy （1 H-MRS） in diagnosis of mild cog- nitive impairment （MCI） with meta-analysis. Methods Relevant studies in Pubmed, CNKI and VIP were searched. Through the test for heterogeneity, the statistics was withdrawn on ROI with different effect models, and the weighted mean difference （WMD） and 95%CI were calculated. Results Totally 26 articles including 19 English articles and 7 Chi- nese articles were brought into this study. The results showed that mI/Cr level of the patient group was higher than that of control group, and the collected WMD was 0.08 （95 % CI= 0.04, 0.12）, of which the differences of hippocampi, cingulated gyrus, temporal lobe and temporal-parietal lobe were statistical. NAA/Cr level of the patient group was lower than that of control group, and the collected WMD was --0.07 （95%CI; --0.10, --0.04）, of which the difference was found only in the area of hippocampi. Cho/Cr level between the two groups had no statistical difference. Conclusion The hippocampi ar- ea is affected significantly by MCI, and the changes of mI/Cr, NAA/Cr may indicate the pathophysiologic process of MCI. The changes of mI/Cr occur earlier than that of NAA/Cr.