ASL技术在阿尔茨海默病早期诊断中的应用价值分析

Analysis of the application value of arterial spin labeling technology in the early diagnosis of Alzheimer’s disease

目的 探析动脉自旋标记(ASL)技术用于测量轻度阿尔茨海默病(SCD)和轻度认知功能损害(MCI)患者脑血流量(CBF)的临床价值,为临床相关诊断提供参考。方法 选取河南省许昌市中心医院神经内科2019年2月—2020年12月收治的108例阿尔茨海默病(AD)患者作为研究对象,其中SCD患者54例(SCD组)、MCI患者54例(MCI组),另选择同期50例接受体检的健康老年人作为对照组研究对象。所有患者均进行3D-ASL技术图像采集,检测双侧8个脑区[苍白球(GP)、壳核(PU)、尾状核(CA)、海马(HP)、丘脑(TH)、额叶皮质(FC)、顶叶皮质(PC)以及枕叶皮质(OC)]的CBF值,并对所得数据进行统计分析。结果 3组研究对象蒙特利尔认知评估量表(MoCA)评分比较,差异具有统计学意义(P<0.05),且得分按照MCI组、SCD组、对照组顺序依次升高。3组研究对象GP、PU、CA、HP、TH、FC、PC、OC的CBF值的差异均具有统计学意义(均P<0.05);其中MCI组研究对象的GP、PU、CA、HP、TH、FC、PC、OC的CBF值均明显低于SCD组及对照组,而SCD组的PU、CA、TH的CBF值明显高于对照组(P<0.05)。此外,研究对象HP、FC、PC、OC的CBF值均与MoCA评分呈正相关(r=0.482,0.325,0.311,0.354,均P<0.05)。结论 ASL技术可以通过精准测量CBF评估AD患者的严重程度,其可为区分SCD及MCI提供参考,值得临床推广。

Objective To investigate the clinical effect of arterial spin labeling(ASL) in measuring cerebral blood flow(CBF) in patients with mild Alzheimer’s disease(SCD) and mild cognitive impairment(MCI) to provide reference for clinical diagnosis. Methods A total of 108 patients with Alzheimer’s disease(AD) admitted to the Neurology Department of Xuchang Central Hospital from February 2019 to December 2020 were selected as the study subjects, including 54 patients with SCD(SCD group) and 54 patients with MCI(MCI group), and another 50 healthy elderly patients who received physical examination during the same period were selected as controls. All patients underwent 3D-ASL image acquisition to detect CBF values in eight bilateral brain regions [globus pallidus(GP), putamen(PU), caudate nucleus(CA), hippocampus(HP), thalamus(TH), frontal cortex(FC), parietal cortex(PC), and occipital cortex(OC)]. The obtained data were statistically analyzed. Results There were significant differences in Montreal Cognitive Assessment(MoCA) scores among the three groups(P<0.05), and the scores increased in turn following the order of MCI group, SCD group, and control group. There were significant differences in CBF values of GP, PU, CA, HP, TH, FC, PC, and OC in the three groups(all P<0.05). The CBF values of GP, PU, CA, HP, TH, FC, PC, and OC in the MCI group were significantly lower than those in the SCD and control groups;while the CBF values of PU, CA, and TH in the SCD group were significantly higher than those in the control group(P<0.05). In addition, CBF values of HP, FC, PC, and OC were positively correlated with MoCA scores in the study subjects(r=0.482, 0.325, 0.311, 0.354, all P<0.05). Conclusion The ASL technique can accurately measure CBF to diagnose the severity of patients with AD and can provide reference for distinguishing SCD from MCI. These benefits hold promise for a wider application of this technique clinically.