磁共振弥散张量成像对预测皮质下缺血性血管性痴呆患者认知功能障碍的价值

The predictive value of MRI diffusion tensor imaging in subcortical ischemic vascular dementia with cognitive impairment

目的应用磁共振弥散张量成像(DTI)技术,探讨皮质下缺血性血管性痴呆(SIVD)患者不同联络纤维感兴趣区弥散张量参数改变与认知功能的关系。方法对60例SIVD患者和40例年龄匹配的非痴呆对照者,采用测定感兴趣区弥散张量参数的方法,比较其纤维束完整性差异及与神经心理学量表的关系。结果 (1)与对照组比较,SIVD组双侧下额枕束、双侧扣带束、左侧上纵束和胼胝体膝部的FA值显著下降及ADC值显著升高;(2)双侧额叶前部皮质下白质FA值与MMSE及Mo CA评分呈明显正相关;(3)双侧海马区、双侧扣带束的FA值与MMSE评分呈明显正相关。结论不同脑区的弥散张量参数变化特点有助于SIVD患者认知功能障碍的早期预测。

Objective To investigate the abnormality of association fiber tracts using diffusion tensor imaging （ DTI ） to detect the relationship between the DT1 paremeters in different regions of interest （ ROI ） and cognitive status in subcortical ischemic vascular dementia （ SIVD ）. Method A region of interest-based DTI approach was applied to explore fiber tract differences and neuropsychological assessments between sixty SIVD patients and forty matched nondemented normal aging. Results （1） Compared with control group, SIVD has significant lower FA and greater ADC in bilateral inferior fronto-oecipital fascicles, the genu of corpus callosum, bilateral cingulate bundles and left superior longitudinal fascicles. （2） The FA value of bilateral frontal subcortical white matter were positively associated with the MMSE scores and MoCA scores.Significant positively correlation was found between MMSE and the FA value of bilateral cingulate bundles and hippoeampal area.Conclusion The changes of DTI parameters in different brain regions may predict the cognitive impairment of SIVD.