遗忘型轻度认知障碍患者脑血流灌注与认知功能的回归分析

Regression analysis of cognitive data and cerebral perfusion in mild amnestic cognitive impaired patients

目的:采用用三维动脉自旋标记(3D-ASL)技术观测轻度认知障碍(aMCI)患者的脑血流变化,探讨脑灌注变化与简易精神状态检查表(MMSE)评分间的关系,为临床早期诊断提供有效的影像学依据。方法:选择年龄、性别配对的17例aMCI患者和21名健康老年人,采用(3D-ASL)序列进行灌注成像。对灌注加权影像采用基于体素分析方法(VBA)进行分析,图像预处理及统计分析采用SPM8。对MMSE评分与灌注参数进行回归分析。采用AlphaSim AFNI程序进行多重比较校正,用以控制假阳性率(P<0.05)。结果:与aMCI患者MMSE评分呈负相关的脑区包括:双侧尾状核,右侧壳核,右侧海马杏仁核,左侧丘脑,右侧额叶眶回,右侧中央前回;呈正相关的为左侧额中回。而正常老年对照组在左侧楔叶,颞上回、双侧颞中回表现出明显与MMSE评分呈正相关。结论:研究表明aMCI患者和健康老年人与认知功能相关的脑区血流灌注存在着明显的差异,3D-ASL成像能够为aMCI患者早期诊断提供有用的影像学依据。

Objective：A preliminary study of 3Darterial spin labeling（3D-ASL）technique in observing the quantitative whole-brain perfusion in patients with mild amnestic cognitive impairment（MACI）was performed.The relationship of MMSE scores for MACI and the change of brain perfusion was investigated in order to provide the imaging evidence for early diagnosis.Methods：Seventeen MACI patients and twenty-one age and gender matched normal senior subjects were recruited in this study.Perfusion scans were performed using 3D-ASL technique.Voxel based analyses（VBA）was used for the analysis of perfusion imaging.SPM8 was used for multiple comparison correction.A second-level regression analysis against MMSE scores was performed to identify disease relevant perfusion abnormalities.AlphaSim program was used for multiple comparison correction,in order to control the false positive rate（corrected P〈0.05）.Results：MACI patients showed negative correlation in bilateral caudate nucleus,right putamen,right hippocampus and amygdala,left thalamus,left frontal orbital lobe,right precentral gyrus,positive correlation in left middle frontal gyrus.In the control group,positive correlation was showed in left cuneus,superior temporal gyrus and bilateral middle temporal gyrus.Conclusion：The perfusion regions which are responsible for cognitive declining in MACI patients and normal seniors were obviously different.3D-ASL technique might provide helpful information in early detection of the disease.