亚临床甲状腺功能减退症的DWI表观弥散系数特点及其与认知功能的关系

Characteristics of DWI Apparent Diffusion Coefficient and Its Relationship with Cognitive Function in Subclinical Hypothyroidism

本研究对亚临床甲状腺功能减退症(SCH)患者的扩散加权成像(DWI)表观弥散系数的特点进行了分析,以探究其与认知功能的关系。选取SCH患者180例,用MMSE量表、HDS量表及MoCA量表对患者进行认知功能评估,将82例认知功能正常患者设为对照组,66例轻度认知功能障碍患者设为轻度组,32例痴呆患者设为痴呆组。所有患者均接受MR-DWI检查,测算头颅各解剖部位的ADC值,并对三组基线资料进行分析。结果显示,三组间年龄、MoCA、MMSE和HDS评分的差异具有统计学意义(P<0.05);右侧海马区、左侧内囊区和左侧半卵圆中心的ADC值均随着认知功能障碍的加重而增大,且轻度组和痴呆组的ADC值明显高于对照组(P<0.05)。由结果可知,年龄递增可增加认知功能障碍的发生风险;认知功能的损害与海马、内囊区、半卵圆中心的代谢和结构改变密切相关。海马区是认知功能由正常进展至轻度障碍的敏感区,半卵圆中心和内囊区是轻度认知功能障碍进展至痴呆的敏感区。

The characteristics of the diffusion-weighted imaging(DWI)apparent diffusion coefficient of patients with subclinical hypothyroidism(SCH)were analyzed to explore the relationship with their cognitive function.180patients with SCH were selected as subjects.After the evaluation of their cognitive function with MMSE scale,HDS scale and MoCA scale,82patients with normal cognitive function were divided into control group,66patients with mild cognitive impairment were divided into mild group,and 32patients with dementia were divided into dementia group.All the patients were underwent MR-DWI examination to measure the ADC values of each anatomical part of the head.The data showed that,the differences in age,MoCA,MMSE,and HDS scores between three groups were statistically significant(P<0.05).The ADC values of MR-DWI in the right hippocampus area,left internal capsule area and left half-oval center all increased with the increase of cognitive dysfunction,and the ADC values of the mild group and dementia group were significantly higher than the control group(P<0.05).The results show that increasing age will increase the risk of cognitive dysfunction.The impairment of cognitive function is closely related to the metabolism and structural changes of the hippocampus,internal capsule,and regional semi-oval center.The hippocampus is a sensitive area where is related to mild cognitive dysfunction,and the internal capsule area is a sensitive area where is related to dementia.