阿尔茨海默病脑磁共振氨基质子转移成像与临床心理量表评分的相关性研究

The correlation between brain MR amide proton imaging and scores of clinical psychometric scales in patients with Alzheimer's disease

目的评价阿尔茨海默病(Alzheimer's disease,AD)患者脑结构磁共振酰胺质子转移(amide proton transfer,APT)成像值与神经心理量表评分的相关性。材料与方法 21例AD患者和19例年龄及性别相匹配的正常对照者进行头颅常规磁共振结构像和APT成像检查。在斜轴位APT像上测量双侧海马、颞叶白质、枕叶白质和大脑脚的酰胺质子(3.5 ppm处)不对称磁化转移率(magnetic resonance ratio asymmetry,MTRasym)。所有受试者均进行简易精神状态量表(mini-mental state examination,MMSE)和临床痴呆评定量表(clinical dementia rating,CDR)的评估。比较正常对照组和AD组各脑结构MTRasym(3.5 ppm)值的差异。以年龄和受教育时间为控制变量,采用偏相关分析比较所有受试者各脑结构MTR_(asym)(3.5 ppm)值与MMSE和CDR评分的相关性。结果 AD组双侧海马的MTRasym(3.5ppm)值显著高于正常对照组[右侧:(0.86±0.32)%和(1.42±0.35)%,t=5.158,P=0.000;左侧:(0.84±0.31)%和(1.39±0.33)%,t=5.225,P=0.000]。双侧海马的MTRasym(3.5 ppm)值均与MMSE评分呈负相关(右侧r=-0.639,P=0.000;左侧r=-0.609,P=0.000),与CDR评分呈正相关(右侧r=0.683,P=0.000;左侧r=0.651,P=0.000)。结论 APT成像能够敏感显示AD患者海马区基于蛋白增加的脑代谢异常,有助于AD的诊断和病情监测。

Objective:To evaluate the correlation between MR amide proton transfer(APT)imaging values of cerebral structures and neuropsychological scores in patients with Alzheimer's disease(AD).Materials and Methods:Twenty-one AD patients and 19 age-and sex-matched normal controls underwent APT and structural MR imaging.The magnetic resonance ratio asymmetry(MTRasym)values at 3.5 ppm of bilateral hippocampi(Hc),temporal white matter regions,occipital white matter regions and cerebral peduncles were measured on the oblique axial APT images.All the subjects were evaluated by Mini-Mental State Examination(MMSE)and clinical dementia rating(CDR).MTRasym(3.5 ppm)values of the cerebral structures between two groups were compared with independent-samples t test.Controlling for age and years of education,partial correlation analysis was used to investigate the correlation between the various MR imaging measures and MMSE,CDR scores among all the subjects.Results:Compared to normal controls,MTRasym(3.5 ppm)in bilateral hippocampi were significantly increased in AD patients[right:(0.86±0.32)%and(1.42±0.35)%,t=5.158,P=0.000;left:(0.84±0.31)%and(1.39±0.33)%.t=5.225,P=0.000].MTRasym(3.5 ppm)values of bilateral Hc were significantly negatively correlated with MMSE scores(right r=-0.637,P=0.000.left r=-0.611,P=0.000)and positively correlated with CDR scores(right r=0.686,P=0.000.left r=0.658,P=0.000).Conclusions:APT imaging can show sensitively hippocampal abnormal metabolite based on increased proteins and peptides in patients with AD,which suggests the technique is a useful tool to diagnose AD and monitor the disease.