脑MRI诊断血管性痴呆与阿尔茨海默病患者的效果比较

Effect comparison of cerebral MRI in diagnosis of vascular dementia and Alzheimer's disease

目的比较脑核磁共振(MRI)诊断血管性痴呆(VD)与阿尔茨海默病(AD)患者的效果。方法选取53例VD患者作为VD组,另选取55例AD患者作为AD组。2组患者均接受脑MRI检查,比较2组患者颞角深度、海马体积与各脑叶体积(额叶、顶叶、颞叶、枕叶)的差异、LA严重度,分析2组的脑MRI影像结果。结果脑MRI对VD患者海马体积检测结果显著高于AD组(P <0. 05),颞角深度显著低于AD组(P <0. 05)。脑MRI检测VD组颞叶与额叶体积显著低于AD组(P <0. 05)。脑MRI检测VD组LA评分为3分与4分的发生率显著高于AD组(P <0. 05),0分与1分的发生率显著低于AD组(P <0. 05)。脑MRI显示,AD组患者脑内未见梗死病灶,VD组患者大血管病变累及区域为大脑前动脉12例,大脑中动脉10例,大脑后动脉6例,顶枕叶分水岭3例;小血管病变累及区域为基底节梗死17例,丘脑梗死5例。结论脑MRI对VD与AD具有显著的鉴别诊断价值。

Objective To compare the efficacy of cerebral magnetic resonance imaging （MRI） in diagnosis of vascular dementia （VD） and Alzheimer′s disease （AD）. Methods Totally 53 patients with VD were selected as VD group, and 55 AD patients were selected as AD group. Both groups received cerebral MRI examination. The differences in the temporal angle depth, the volume of the hippocampus and the volume of the brain lobes （frontal, parietal lobe, temporal lobe, occipital lobe） and the severity of LA were compared between the two groups, and the results of cerebral MRI imaging were analyzed. Results The volume of hippocampal volume in patients with VD was significantly higher than that in patients with AD （ P 〈0.05）, and the depth of temporal horn was significantly lower than patients with AD （ P 〈0.05）. The detection values of temporal and frontal lobes in group VD were significantly lower than group AD （ P 〈0.05）. Cerebral MRI showed that the incidence rate of LA score at 3 points and 4 points in group VD was significantly higher than that in group AD （ P 〈0.05）, and the incidence rate of 0 point and 1 point was significantly lower than group AD （ P 〈0.05）. The cerebral MRI showed that there was no infarct in the brain of group AD, but in group VD, there were 12 cases of anterior cerebral artery, 10 cases of middle cerebral artery, 6 casesof posterior cerebral artery, 3 cases of top occipital lobe watershed, 17 cases of basal ganglia infarction in small vascular lesions and 5 case of thalamus infarction. Conclusion Cerebral MRI has a significant differential diagnostic value for VD and AD.