轻度认知损害及轻中度阿尔茨海默病海马亚区MRI体积的研究

MRI Study of the Hippocampal Subregional Volume in Patients with Mild Cognitive Impairment and Mild-to-Moderate Alzheimer's Disease

目的探讨轻度认知损害(MCI)、轻度及中度阿尔茨海默病(AD)患者双侧海马头、体、尾各亚区体积的改变,为MCI、AD的临床早期诊疗提供影像学帮助。方法搜集MCI、轻度及中度AD患者和老年健康志愿者各20例,所有受试者均在1.5 T磁共振下行快速场回波(FFE)3D序列检查,测量并分析双侧海马整体体积及头体尾各亚区体积变化。结果左侧及右侧海马整体体积在4组间差异有统计学意义(左侧:F=61.18,P<0.01;右侧:F=42.02,P<0.01),且除MCI与轻度AD间差异无统计学意义外(P>0.05),其余两两之间比较差异均有统计学意义。亚区体积:左侧海马头部:4组间差异有统计学意义(F=56.07,P<0.01)且各组间两两比较差异均有统计学意义;右侧海马头部:4组间差异有统计学意义(F=46.19,P<0.01),但两两比较时MCI与轻度AD间差异无统计学意义;左侧海马体部:4组间差异有统计学意义(F=15.65,P<0.01),但两两比较时仅中度AD与其余各组间差异有统计学意义;右侧海马体部及双侧海马尾部4组间差异无统计学意义(P>0.05)。结论 MCI、轻中度AD患者双侧海马整体体积及部分亚区体积存在萎缩,而对左侧海马头部的早期定量测量,将有助于对MCI、AD的早期诊断及鉴别诊断。

Objective To investigate the changes of the hippocampal sub-regional volume in patients with mild cognitive impairment （MCI） and mild-to-moderate Alzheimer＇s disease （AD） by using MRI in order to provide useful reference for early diagnosis of MCI and AD. Methods Twenty patients with MCI and mild-to-moderate AD （ study group） as well as 20 healthy aged volunteers （ control group） were enrolled in this study. With a 1.5 T MR unit MRI scanning using FFE3D sequence was performed in all patients and volunteers. The total volume as well as the sub-regional volumes （ head, body and tail of the hippoeampus were determined. The results were analyzed and compared between groups. Results Significant differences in the total left as well as fight hippocampal volume and in the volume of the fight hippoeampal head existed between the four groups （left： F = 61.18, P 〈 0.01 ;right：F = 42. 02, P 〈 0.01 ）, except that the difference between the MCI and mild AD was not significant. For the comparison of sub-regional volumes, significant differences existed among the four groups （ F = 56. 07 ,P 〈 0.01 ） as well as between each other of the four groups. The differences in the volumes of fight hippocampal body among the four groups were statistically significant （ F = 46. 19, P 〈 0.01 ）, although no significant difference existed between MCI and mild AD. The differences in the volumes of left hippocampal body among the four groups were statistically significant （F = 15.65 ,P 〈 0.01 ）, however, significant difference existed only between moderate AD and other groups. No significant differences in the volume of right hippocampal body and bilateral hippocampal tails existed between the four groups （P 〉 0.05）. Conclusion In patients with MCI and mild-to-moderate AD, bilateral total hippocampal volumes and some sub-regional volumes are reduced. The quantitative measurement of the volume of left hippocampal head is very helpful in making clinical diagnosis and differentiation of MCI and AD at its early stage.