脑小血管病的影像学表现与认知功能障碍的关系

Relationship between the imaging manifestations of cerebral small vessel disease and cognitive dysfunction

目的探讨脑小血管病的影像学表现及与认知功能障碍的关系。方法选择2015年5月~2017年7月自愿到科室接受治疗的脑小血管病患者65例,根据患者是否伴有认知功能障碍分为认知功能障碍组(n=23例)和非认知功能障碍组(n=42例)。两组入院后均采用蒙特利尔认知评估(MoCA)、日常生活活动能力(ADL)和简易智力状态检查量表(MMSE)对患者认知功能进行评估,并且患者均采用MRI检查,获得弥散系数(ADC)参数,采用Pearson相关性分析软件对脑小血管病的影像学表现与认知功能障碍关系进行分析。结果认知功能障碍组蒙特利尔认知评估、日常生活活动能力评分,低于非认知功能障碍组(P<0.05);认知功能障碍组简易智力状态检查量表,高于非认知功能障碍组(P<0.05);认知功能障碍组左侧尾状核ADC值水平,高于非认知功能障碍组(P<0.05);认知功能障碍组左侧、右侧半卵圆中心、左侧尾状核、左侧右侧丘脑及额叶部位ADC值,均低于非认知功能障碍组(P<0.05);Pearson相关性分析结果表明:MoCA评分与ADC值中左侧、左侧尾状核、右侧丘脑、左右额叶位ADC值无相关性;MOCA评分与左侧丘脑呈正相关性(P<0.05)。结论脑小血管病合并认知功能障碍患者影像学特点与认知功能障碍之间呈正相关性,能为临床治疗提供影像学依据。

Objective To investigate the relationship between the imaging manifestations of cerebrovascular disease and cognitive dysfunction. Methods From May 2015 to July 2017, 65 patients with cerebrovascular disease who were vol- untarily admitted to the department were selected. The patients were divided into cognitive dysfunction group（n=23） and non-cognitive dysfunction group （n=42） according to whether the patients were complicated with cognitive dysfunction. Patients in both groups were assessed for cognitive function by MoCA,ADL and MMSE after admission, and the patients were given MRI examination to obtain the diffusion coefficient（ADC）. SPSS Pearson correlation analysis software was used to analyze the relationship between the imaging manifestations of cerebrovascular disease and cognitive dysfunction. Results The scores of Montreal cognitive assessment and the scores of activity of daily living in the cognitive dysfunction group were lower than those in the non-cognitive dysfunction group （P〈0.05）; the simple mental status examination scale in the cognitive dysfunction group was higher than that in the non-cognitive dysfunction group（P〈0.05）; the ADC value of the left caudate nucleus in the cognitive dysfunction group was higher than that in the non-cognitive dysfunction group（P〈0.05）; the scores of ADC in left, right hemicegius, left caudate nucleus, left and right thalamus and frontal lobe in the cognitive dysfunction group were lower than those in the non-cognitive dysfunction group（P〈0.05）; Pearson correlation analysis showed that： there was no correlation between the MoCA score and the ADV value of the left caudate nucleus, right thalamus, the left and right frontal lobe ADC（P〉0.05）. MoCA score was positively correlated with left thaloamus（P〈0.05）. Conclusion There is a positive correlation between the imaging features and cognitive dysfunction in the patients with cerebrovascular disease complicated with cognitive dysfunction, which can provide imaging evidence for clinical treatment.