海马萎缩的磁共振定量分析在痴呆与轻度认知损害之间的价值

Quantitative MR Evaluation of Hippocampal Volumes: Comparison with Alzheimer's Disease and Mild Cognitive Impairment

目的探讨老年人海马体积的变化及其与认知功能障碍之间的相关性。方法收集正常受试者26名、阿尔茨海默病(AD)患者35名、轻度认知损害(MCI)患者41名,采用SIEMENS 1.5T超导型核磁共振依次行头颅MRI检查,并测量海马体积(Hippocampal volume,HV)。结果正常对照组(CG)的MMSE分数为(29.8±0.3),AD组的MMSE分数为(17.5±3.8),MCI组的MMSE分数为(26.3±1.9),AD组与CG组之间有显著差异(P<0.05),MCI组与CG组之间无显著差异(P>0.05),AD组与MCI组之间有显著差异(P<0.05)。CG组海马体积为左侧(2.78±0.27)cm^3、右侧(2.79±0.26)cm^3、总体积(5.57±0.52)cm^3,AD组左侧(1.75±0.31)cm^3、右侧(1.83±0.30)cm^3、总体积(3.58±0.61)cm^3,MCI组左侧(2.54±0.25)cm^3、右侧(2.58±0.28)cm^3、总体积(5.12±0.54)cm^3,CG组与AD组、AD组与MCI组之间的差异均显著(P<0.0001),CG组与MCI组之间也存在明显差异(P<0.05)。结论测量HV结合MMSE评分可以作为评估老年人AD的诊断标准之一。但在MCI的早期诊断中,测量HV较为敏感,而MMSE分数不敏感。相比评估AD的价值,测量HV在MCI的早期诊断中起着更重要的作用。

Objective To explore the changes in the volume of the hippocampus and its correlation with cognitive impairment.Methods A total of 26 cognitively normal subjects,35 patients with AD,and 41 patients with MCI were enrolled.Hippocampal volume was measured using magnetic resonance imaging(MRI)machine by manual segmentation(MEGNATOM ESSENZA 1.5 T scanner).Results Mean mini–mental status examination(MMSE)score of control group was(29.8±0.3).In the AD group,MMSE was(17.5±3.8).In the MCI group,MMSE was(26.3±1.9).There was a statistically significant difference between control and AD,AD and MCI(P<0.05),but not between control and MCI(P >0.05)subjects.In the control group,the hippocampal volume was(2.78±0.27)cm^3 on the left side,(2.79±0.26)cm^3 on the right side and the total volume was(5.57±0.52)cm^3.Likewise,in the AD group,the volume on the left side it was(1.75±0.31)cm^3,on the right side was(1.83±0.30)cm^3,and the total volume was(3.58±0.61)cm3.Similarly,in MCI,the volume on the left side was(2.54±0.25)cm^3 and the volume on the right side was(2.58±0.28)cm^3,and the total volume was(5.12±0.54)cm^3.There was a statistically significant difference between control and AD,AD and MCI(P<0.0001),and between control and MCI(P<0.05)subjects.Conclusion The measurement of HV combined with MMSE can be used as one of the diagnostic criteria for evaluating the elderly AD.However,in the early diagnosis of MCI,HV was sensitive while the MMSE score was not.Measurement of HV plays an important role in early diagnosis of MCI.