阿尔茨海默病、血管性痴呆及额颞叶变性患者的脑MRI及CT平扫影像学特征分析

Brain MRI and CT Plain Imaging Features in Patients with Alzheimer's Disease, Vascular Dementia and Frontotemporal Lobar Degeneration

目的探讨阿尔茨海默病、血管性痴呆及额颞叶变性患者的脑MRI平扫及行CT平扫影像学特征。方法回顾性分析我院收治的100例痴呆患者,其中AD组患者35例、VD组患者34例、FTLD组患者31例。分别应用MRI平扫及行CT平扫,建构测试网,进行评估。结果 AD组患者中皮质萎缩、脑沟增宽、海马内侧脑脊液池增宽发生率显著高于VD组、FTLD组(P<0.05)。AD组海马萎缩、颞顶叶萎缩发生率高于VD组、FTLD组(P<0.05),病灶出血发生率低于VD组(P<0.05)。三组白质稀疏发生率比较无差异(P>0.05),VD组病灶出血发生率高于FTLD组(P<0.05),海马萎缩发生率与FTLD组比较无差异(P>0.05)。AD组颢叶内侧萎缩、全脑皮层萎缩评分显著高于VD组、FTLD组(P<0.05),VD组颢叶内侧萎缩、全脑皮层萎缩评分显著高于FTLD组(P<0.05)。结论痴呆在CT平扫影像不清,而MRI平扫能有效鉴别老年痴呆,其中颢叶内侧萎缩、全脑皮层萎缩可作为早期痴呆特异及敏感的诊断指标。

Objective To investigate the brain MRI and CT plain imaging features in patients with Alzheimer＇s disease（AD）, vascular dementia（VD） and frontotemporal lobar degeneration（FTLD）. Methods A total of 100 cases of dementia patients treated in our hospital from January 2016 to January 2017 were retrospectively analyzed, including 35 cases of AD patients, 34 cases of VD patients, 31 cases of FTLD patients. All patients received brain MRI and CT plain scan. Results The cortical atrophy, widened sulci, widened hippocampus cerebrospinal fluid occurred in AD group, VD group and FTLD group, the incidence rate of the above indicators was highest in the AD group（P〈0.05）. The hippocampus atrophy, temporoparietal lobe atrophy, hemorrhage, white matter rarefaction occurred in AD group, VD group and FTLD group. The incidence rate of hippocampus atrophy and temporoparietal lobe atrophy in AD group was higher than that in the VD group and FTLD group（P〈0.05）, the incidence rate of hemorrhage in AD group was lower than that in the VD group（P〈0.05）, no difference was found in the incidence of white matter rarefaction（P〉0.05）. The incidence rate of temporal cortex lobe atrophy and cerebral atrophy in three groups from low to high were FTLD group, VD group and AD group（P〈0.05）. Conclusion Dementia is not clear on the CT plain scan, and MRI plain scan is significant for the identification of dementia. The temporal cortex lobe atrophy and cerebral atrophy can be used as the most specific and sensitive diagnostic indicators.