双侧基底节筛孔状态的MRI表现及可能的临床意义

Cribriform state in the basal ganglia:its imaging features and possible correlation with cognitive impairment

目的:探讨双侧基底节筛孔状态的MRI表现及可能的临床意义。方法:选取63例双侧基底节筛孔状态患者作为病例组,并通过MRI评价其病灶形态、信号特点;同时选取63例性别、年龄相匹配的正常志愿者作为对照组,病例组及对照组均进行中文版简易智能状态检查量表(MMSE)评分;并按性别分层,研究高血压与双侧基底节筛孔状态的关系。结果:所有病灶集中于双侧壳核、豆状核,且呈双侧对称性、筛孔状分布;病灶在T_2WI上呈高信号,T_1WI及FLAIR T_2WI上呈低信号,无明确壁或胶质增生表现,扩散未见明确受限表现。病例组的MMSE总评分[(26.00±1.95)分]较对照组[(28.44±1.15)分]低,且两者间差异具有统计学意义(Z=-7.15,P<0.001)。分层χ2检验结果提示两性高血压与筛孔状态均存在相关性(χ_M^2=19.19,P_M<0.001;χ_F^2=13.60,P_F=0.001)。结论:双侧基底节筛孔状态是一种病理改变,与患者认知功能损伤有一定关系,高血压可能是其中一个危险因素,应引起临床重视。

Objective：To investigate the MRI features of cribriform state in the basal ganglia and correlations with cognitive impairment.Methods：Imaging archive of 63 patients with cribriform state was reviewed.All patients underwent the brain MR examination.Lesions were evaluated by size and signal intensity.All the patients with cribriform state and 63age-and gender-matched controls underwent mini-mental state examination（MMSE）.Besides,the correlation between hypertension and cribriform state was evaluated with Mantel-Haenszel statistic.Results：T2-weighted MRI shows bilateral innumerable high-intensity spots in both putamen and caudate nucleus.There were no signs of acute infarct on DWI.The MMSE scores of cribriform state group and control group were（26.00±1.95）and（28.44±1.15）,respectively.The difference of the MMSE scores between two group was statistically significant（Z=-7.15,P〈0.001）.Significant correlation existed between hypertension and cribriform state（χM^2=19.19,PM 0.001;χF^2=13.60,PF=0.001）.Conclusion：Cribriform state is always abnormal,it may correlate with cognitive impairment in the elderly people.Hypertension may be one of the risk factors of cribriform state.