MR动脉自旋标记观察不同阶段阿尔茨海默病脑血流量

MR arterial spin labeling for evaluation on cerebral blood flow of different stage Alzheimer disease

目的采用MR动脉自旋标记(ASL)观察不同阶段阿尔茨海默病(AD)患者脑血流量(CBF)的差异。方法回顾性分析39例SCD(SCD组)、12例轻度认知障碍(MCI)及7例痴呆患者[将MCI及痴呆患者归为认知障碍(CI)组],观察其颅脑ASL,比较组间一般资料及CBF的差异,分析CBF与蒙特利尔认知评估(MoCA)及简易智能精神状态检查量表(MMSE)评分的相关性。结果SCD组患者受教育年限、MoCA评分及MMSE评分均高于CI组(P均<0.05)。相比SCD组,CI组白质、灰质及全脑CBF显著降低(P均<0.05);其中,颞叶、枕叶、后扣带回及楔前叶CBF组间差异有统计学意义(P均<0.05)。双侧颞下回、双侧枕下回、双侧后扣带回及双侧楔前叶CBF均与MoCA及MMSE评分呈正相关(r=0.29~0.49,P均<0.05)。结论MCI+痴呆阶段AD患者CBF显著低于SCD阶段,且CBF与认知水平呈正相关。

Objective To observe cerebral blood flow(CBF)in different stage Alzheimer disease(AD)with MR arterial spin labeling(ASL).Methods Data of 39 patients with SCD(SCD group),12 with mild cognitive impairment(MCI)and 7 patients with dementia(MCI and dementia patients were enrolled in cognitive impairment[CI]group)were retrospectively analyzed.Brain ASL was performed,and the general data and CBF of patients were compared between groups.The correlations of CBF with Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)score were evaluated.Results The educated level,MoCA score and MMSE score of SCD group were all higher than those of CI group(both P<0.05).Compared with SCD group,CBF of white matter,gray matter and whole brain of CI group decreased significantly(all P<0.05),and significant differences of CBF were found between groups in temporal lobe,occipital lobe,posterior cingulate gyrus and anterior cuneiform lobe(all P<0.05).In AD patients,CBF of bilateral inferior temporal gyrus,bilateral inferior occipital gyrus,bilateral posterior cingulate gyrus and bilateral anterior cuneiform lobe were positively correlated with MoCA and MMSE scores(r=0.29—0.49,all P<0.05).Conclusion CBF of AD patients in MCI+dementia stage were significantly lower than in SCD stage,which were positively correlated with patients'cognitive levels.