DTI脑网络分析对早期卒中后认知障碍的预测价值

The predictive value of DTI brain networks analysis for predicting early post stroke cognitive impairment

目的探讨扩散张量成像(diffusion tensor imaging,DTI)脑网络分析对早期卒中后认知障碍(post stroke cognitive impairment,PSCI)的预测价值。方法选取2018年12月至2019年12月间我院收治的62例早期PSCI患者作为观察组(PSCI组),并招募同期60例健康体检者作为对照组。观察对比两组的DTI检查结果,蒙特利尔认知量表(MoCA)评分,并将各向异性分数(FA)和MoCA评分进行相关性分析,绘制ROC曲线评估DTI对PSCI的预测效能。结果PSCI组两侧额叶、两侧海马、胼胝体FA值均低于对照组(P<0.05);两侧额叶、海马、及胼胝体FA值均与MoCA评分呈正相关;右侧海马FA值预测早期PSCI的最佳截点为0.22,AUC为0.911,显著优于左侧海马FA、右侧额叶FA、胼胝体FA,右侧海马FA、左侧海马FA、左侧额叶FA诊断敏感性分别为93.50%、85.52%、83.92%,显著优于其他指标(P<0.05)。结论DTI可显示早期PSCI患者脑结构网络存在的连接异常,两侧额叶、两侧海马、胼胝体脑白质区域FA值改变对PSCI发生具有良好的预测效果。

Objective To investigate predictive value of diffusion tensor imaging(DTI)brain networks analysis for predicting early post stroke cognitive impairment(PSCI).Methods A total of 62 early PSCI patients in our hospital from December 2018 to December 2019 were collected as the observation group(PSCI group),and 60 healthy subjects were recruited as the control group.DTI results and montreal cognitive assessment(MoCA)between the two groups were compared.Correlation analysis was carried out between the fractional anisotropy(FA)and MoCA score,and the ROC curve was drawn to evaluate the predictive efficiency of DTI on PSCI.Result The FA values of bilateral frontal lobe,bilateral hippocampus and corpus callosum in the PSCI group were all lower than those in the control group(P<0.05).The FA values of both frontal hippocampus and corpus callosum were positively correlated with MoCA score.The optimal cut-off point of early PSCI predicted by FA value of the right hippocampus was 0.22 and AUC was 0.911,which was significantly better than that of the left hippocampus,the right frontal lobe and the corpus callosum.The diagnostic sensitivity of FA of the right hippocampus,the left hippocampus and the left frontal lobe were 93.50%,85.52%and 83.92%,respectively,which were significantly better than other indicators(P<0.05).Conclusion DTI can show the abnormal connection of brain structural network in patients with early PSCI,and the FA value changes in bilateral frontal lobes,bilateral hippocampus and corpus callosum have a good prediction effect on the occurrence of PSCI.