阿尔茨海默病脑内深部核团磁敏感相位值与MMSE的相关性研究

Study on the correlation between the phase of the magnetic sensitivity of the deep nucleus of the brain and the MMSE in AD patients

目的利用磁敏感加权成像(susceptibility-weighted imaging,SWI)评价阿尔茨海默病(Alzheimer's disease,AD)患者深部脑核团铁沉积,并分析其与简易智力状况评分(mini-mental state examination,MMSE)的相关性。材料与方法自2015年11月至2016年12月期间,募集AD患者17例,年龄47～82岁,同期就诊的21名认知正常者作为对照,年龄48～78岁。扫描设备选用Philip Ingenia3.0 T全数字磁共振扫描仪,头部8通道相控阵线圈,受试者均行头磁共振常规扫描及磁敏感加权成像序列扫描,测量双侧尾状核头、丘脑、壳核、苍白球、黑质及红核的相位值。采用SPSS 19.0和Med Cal方法比较病例组与对照组相位值的差异,并对相位值与简易智力状况评分进行Spearman相关分析,对相关系数r值进行t检验(P<0.05)。结果病例组与对照组双侧尾状核头、右侧黑质相位值差异有统计学意义(P<0.01);双侧苍白球、双侧壳核、双侧丘脑、双侧红核及左侧黑质相位值差异无统计学意义(P>0.05)。病例组中双侧黑质、双侧尾状核相位值与其MMSE评分呈正相关。结论磁敏感相位值能半定量评估脑内铁沉积,对AD诊断有一定价值。

Objective:To evaluate the iron deposition in deep brain nucleus of Alzheimer’s disease(AD)patients and determine its correlation with MMSE score using susceptibility-weighted imaging(SWI).Materials and Methods:From November 2015 to December 2016,21 cognitively normal subjects(4 male,13 female,age 47 to 82)and 17 patients(9 male,12 female,age 48 to 78)with Alzheimer’s disease were scaned with both routine MRI sequences and SWI sequences using Philip Ingenia 3.0 T MRI.Software is used to generate SWI pictures.The phase value of caudate nucleus,substantia nigra,red nucleus,globus pallidus and putamen were measured in the corrected phase images.Then calculate the correlations between phase value and mini-mental state examination(MMSE)score.Statistical analysis is done by SPSS and MedCalc software package.First compare the phase value of caudate nucleus,substantia nigra,red nucleus,globus pallidus,and putamen between Alzheimer’s patients and control group.Then calculate the correlations between phase value and MMSE score(P<0.01).Results:In SWI sequences,the phase value of right substantia nigra and bilateral caudate nucleus between AD patients and healthy people are significantly different(P left caudate nucleus<0.001,P right caudate nucleus=0.002,P right substantia nigra=0.012).Correlation between iron deposition in right substantia nigra and bilateral caudate nucleus and MMSE score in AD patients were found.Conclusions:SWI technology can reflect the iron deposition in deep brain gray nucleus in AD patients respectively and non-invasively,thus helping the early diagnosis of AD.