脑萎缩伴随精神障碍的老年患者的头颅CT诊断分析

Diagnosis of elderly brain atrophy patients with mental disorder according to their CT image

目的观察脑萎缩伴随精神障碍的老年患者的头颅CT检查影像学征象,并分析其相关临床因素。方法选取本院收治的老年脑萎缩伴随精神障碍患者40例为A组,无伴随精神障碍的老年脑萎缩患者与头颅CT检查结果正常的健康老年人各40例,分别为B组和C组。回顾性分析3组CT的影像特征,测量3组影像学指标,包括双侧侧脑室宽度、脑沟宽度、侧裂池宽度和脑白质的CT值,进行统计学分析。结果与C组比较,A组和B组的侧脑室宽度、脑沟宽度、侧裂池宽度明显增加[(17.2±4.9)mm和(15.7±3.9)mmvs(12.2±3.0)mm,(8.7±2.8)mm和(6.9±2.5)mmvs(3.9±1.0)mm,(24.3±5.1)mm和(20.8±4.5)mmvs(14.3±3.2)mm,P=0.000],而脑白质的CT值明显降低[(28.2±4.3)HU和(33.9±5.0)HUvs(38.1±6.3)HU,P=0.000]。与B组比较,A组的脑沟侧裂池宽度明显增加,脑白质的CT值显著降低(P<0.05)。A组发生脑梗死和脑白质脱髓鞘比例显著高于B组(40.0%vs 17.5%,P=0.26;47.5%vs 25.0%,P=0.36)。结论伴有精神障碍的老年脑萎缩患者的CT表现更严重,伴有脑白质脱髓鞘或脑梗死的老年脑萎缩患者更易出现精神障碍。

Objective To analyze the clinical factors associated with CT image in diagnosis of elderly brain atrophy patients with mental disorder.Methods Forty elderly brain atrophy patients with mental disorder served as group A,40 elderly brain atrophy patients without mental disorder served as group B,and 40 healthy people served as group C in this study.The chacteristics of their CT image were retrospectively analyzed.Their CT imaging indicators（including the width of ventricle,brain pool,brain ditch and the CT value of white matter）were recorded and analyzed.Results The width of ventricle,brain pool,brain ditch and the CT value of white matter were significantly different in 3 groups（P〈0.01）.The width of ventricle,brain pool,brain ditch was significantly longer while the CT value of white matter was significantly lower in groups A and B than in group C（17.2±4.9 mm and 15.7±3.9 mmvs 12.2±3.0 mm,8.7±2.8 mm and 6.9±2.5 mmvs 3.9±1.0 mm,24.3±5.1 mm and 20.8±4.5 mmvs 14.3±3.2 mm,28.2±4.3 HU and 33.9±5.0 HUvs 38.1±6.3 HU,P=0.000）.The width of brain ditch was significantly longer while the CT value of white matter was significantly lower in group A than in group B（P〈0.05）.The incidence of ischemic stroke and white matter demyelination was significantly higher in group A than in group B（40.0%vs 17.5%,P=0.26;47.5%vs 25.0%,P=0.36）.Conclusion Brain atrophy patients with mental disorder demonstrate worse CT findings and those with white matter demyelination and ischemic stroke are more prone to occur mental disorder.