非痴呆型血管性认知功能障碍的磁共振波谱分析特点

Magnetic resonance spectroscopy features of vascular cognitive impairment with no dementia

目的探讨非痴呆型血管性认知功能障碍（VCIND）患者的磁共振波谱分析（MRS）特点。方法对100例VCIND患者和50名健康志愿者进行MRS检查，检测多体素’H—MRS代谢值：N一乙酰天门冬氨酸（NAA）、乙酰胆碱（Cho）、肌酸（cr）及NAA／Cr、Cho／Cr。结果VCIND组双侧额叶、后扣带回、丘脑和右侧角回Cho值及左侧后扣带回Cho／Cr值明显高于对照组（P〈0．05—0．01）；VCIND组右侧后扣带回NAA／Cr值明显低于对照组（P〈0．01）。VCIND组优势侧额叶、角回Cho值及优势侧后扣带回Cho／Cr值明显高于对侧（P〈0．05～0．01）；VCIND组优势侧角回NAA值及优势侧额叶、角回NAA／Cr值明显低于对侧（均P〈0．01）。对照组优势侧角回Cho值明显高于对侧（P〈0．01）；对照组优势侧额叶NAA值及优势侧额叶、角回NAA／Cr值明显低于对侧（P〈0．05～0．01）。结论VCIND患者大脑广泛代谢异常，但以右侧后扣带回及优势半球的后扣带回和额叶最为敏感。

Objective To investigate the magnetic resonance spectroscopy （MRS） features of patients with vascular cognitive impairment with no dementia （VCIND）. Methods One hundred VCIND patients and 50 healthy volunteers were detected by MRS. And the 1H-MRS value： N-acety laspartate （NAA）, Choline （Cho）, Creatine （Cr） and NAA/Cr, Cho/Cr were measured. Results The values of Cho in bilateral frontal lobe, posterior cingulate gyrus, thalamus and right angular gyms and the value of Cho/Cr in left posterior eingulate gyrus of VCIND group were significantly higher than that of control group （ P 〈 0. 05 - 0.01 ）. The value of NAA/Cr in right posterior cingulate gyrus of VCIND group was significantly lower than that of control group （P 〈 0. 01 ）. The values of Cho in dominant hemisphere frontal lobe, angular gyrus and the values of Cho/Cr in dominant hemisphere posterior eingulate gyrus of VCIND group were siguificantly higher than that in the other side （ P 〈 0. 05 - 0.01 ）. The value of NAA in dominant hemisphere angular gyrus and the values of NAA/Cr in dominant hemisphere frontal lobe, angular gyrus of VCIND group were significantly lower than that in the other side （ all P 〈 0.01 ）. The value of Cho in dominant hemisphere angular gyrus of control group was significantly higher than that in the other side （ P 〈 0. 01 ）. The value of NAA in dominant hemisphere frontal lobe and the values of NAA/Cr in dominant hemisphere frontal lobe, angular gyrus of control group were significantly lower than that in the other side （P 〈 0. 05 - 0.01 ）. Conclusion VCIND patients have extensive metabolic disturbance, which in the right posterior cingulate gyrus and dominant hemisphere posterior cingulate gyms, frontal lobe is the most sensitive.