缺血性小血管病变MR影像学表现与血管性认知功能障碍的相关性

Correlation between MR imaging and vascular cognitive dysfunction in ischemic small vessel disease

目的探讨缺血性小血管病变MR影像学表现与血管性认知功能障碍(VCI)的相关性。方法收集2017年1月-2018年12月绵阳市第三人民医院收治的缺血性小血管病患者100例为研究对象,采用蒙特利尔认知评估量表(MoCA)和简易精神量表(MMSE)对患者进行评分,根据出院后6个月MMSE和MoCA评分分为VCI组(MMSE<27分,MoCA≤27分)44例和非VCI组(MMSE≥27分,MoCA>27分)56例,对其临床资料和MR影像学检查进行分析。结果VCI组额叶、基底节梗死发生率高于非VCI组,差异具有统计学意义(χ^2=3.834、2.770,P<0.05);VCI组海马沟回间距及侧脑室体部宽度指数显著高于非VCI组,差异具有统计学意义(t=2.816、2.257,P<0.05);VCI组LI分级、LA分级2级+3级占比高于非VCI组,差异均有统计学意义(χ^2=3.244,4.268,P<0.05);根据Pearson相关性分析,CSVD的VCI发生与腔隙性脑梗死病灶部位、LI分级,LA分级呈正相关(r=0.412,0.560,0.550,P=0.025,0.011,0.010);CSVD的VCI发生与脑萎缩线性指标不相关(r=0.315,P>0.05)。结论CSVD患者额叶、基底节梗死,梗死灶≥4个,2、3级LA可作为VCI的预测指标。

Objective To explore the correlation between MR imaging and vascular cognitive impairment(VCI).Methods From January 2017 to December 2018,100 patients with ischemic small blood vessel disease admitted to the third People’s Hospital of Mianyang City were collected as research objects.The patients were assessed with the Montreal Cognitive Assessment Scale(MoCA)and the mini mental Inventory(MMSE).According to the MMSE and MOCA scores of 6 months after discharge,44 patients in VCI group(MMSE<27,MoCA≤27)and 56 patients in non VCI group were divided.The clinical data and MR imaging examination were analyzed.Results The incidence of frontal lobe and basal ganglia infarction in VCI group was significantly higher than that in non VCI group(χ^2=3.834,2.770,P<0.05).VCI group was significantly higher than non VCI group(t=2.816,t=2.257,P<0.05).The proportion of LI and LA in VCI group was higher than that in non VCI group(χ^2=3.244,4.268,P<0.05).According to Pearson’s correlation analysis,the VCI of CSVD was positively correlated with the location,grade and La grade of lacunar cerebral infarction(r=0.412,r=0.560,r=0.550,P=0.025,P=0.011,P=0.010).VCI of CSVD was not correlated with linear index of brain atrophy(r=0.315,P>0.05).Conclusion In CSVD patients,frontal lobe and basal ganglia infarctions,infarctions≥4,and LA of grade 2 and 3 can be used as a predictor of VCI.