扩张的血管周围腔隙在阿尔茨海默病海马萎缩中的作用

Role of Dilated Virchow-Robin Space in Hippocampal Atrophy in Alzheimer’s Disease

目的:探讨扩张的血管周围腔隙(dVRS)存在状态在阿尔茨海默病患者海马萎缩中所起的作用。方法:收集77例阿尔茨海默病患者和30例正常受试者,采用3.0T高场磁共振对所有受试者的海马以及其内dVRS进行扫描成像并进行三维重建分析。比较海马内dVRS分布、数目以及体积大小与海马萎缩程度的相关性,将dVRS形态学指标对海马体积萎缩的预测价值进行ROC曲线分析。结果:阿尔茨海默病患者的双侧海马较正常受试者明显萎缩,海马内dVRS表现更为明显,差异具有统计学意义(P<0.05),其中海马头部dVRS占比高、分布多;dVRS数目及总体积与海马体积均呈负相关性(左侧海马dVRS数目与左侧海马体积相关系数:r=-0.486,P<0.05;左侧海马dVRS总体积与左侧海马体积相关系数:r=-0.572,P<0.05;右侧海马dVRS数目与左侧海马体积相关系数:r=-0.421,P<0.05;右侧海马dVRS总体积与左侧海马体积相关系数:r=-0.465,P<0.05);ROC曲线分析表明dVRS存在状态对阿尔茨海马病患者海马体积萎缩的预测价值明显(左侧海马dVRS数目AUC=0.845,灵敏度66.76%,特异度94.81%;左侧海马dVRS总体积AUC=0.920,灵敏度76.67%,特异度98.70%;右侧海马dVRS数目AUC=0.722,灵敏度60.00%,特异度83.12%;右侧海马dVRS总体积AUC=0.872,灵敏度80.00%,特异度81.82%)。结论:海马中dVRS存在状态对阿尔茨海默病患者的海马萎缩具有一定的预测价值。

Objective:To investigate the role of the dilated Virchow-Robin space(dVRS)in hippocampal atrophy in Alzheimer’s disease.Methods:A total of 77 patients with Alzheimer’s disease and 30 normal subjects were collected.The hippocampal structure and internal dVRS of all subjects were scanned by 3.0T high-field magnetic resonance imaging and three-dimensional reconstruction analysis was performed.The correlation between the distribution,number and volume of dVRS in the hippocampal structure and the degree of hippocampal atrophy was compared,and the predictive value of dVRS morphological index on hippocampal atrophy was analyzed by ROC curve.Results:The hippocampal volume of patients with Alzheimer’s disease was significantly atrophy compared with normal subjects,and the dVRS in the hippocampus were more obvious,the difference was statistically significant(P<0.05).In Alzheimer’s disease patients with high proportion of dVRS in hippocampal head.The number and total volume of dVRS were negatively correlated with the volume of hippocampus(correlation coefficient between the number of dVRS in the left hippocampus and the volume of the left hippocampus:r=-0.486,P<0.05;Correlation coefficient between the total volume of dVRS in the left hippocampus and the volume of the left hippocampus:r=-0.572,P<0.05;correlation coefficient between the number of dVRS in the right hippocampus and the volume of the left hippocampus:r=-0.421,P<0.05;Correlation coefficient between the total volume of dVRS in the right hippocampus and the volume of the left hippocampus:r=-0.465,P<0.05).ROC curve analysis showed that the predictive value of dVRS in hippocampal volume atrophy in patients with Alzheimer’s disease was obvious(the number of dVRS in left hippocampus was AUC=0.845,the sensitivity was 66.76%,the specificity was 94.81%,total dVRS volume in the left hippocampus was AUC=0.920,the sensitivity was 76.67%,the specificity was 98.70%;the number of dVRS in right hippocampus was AUC=0.722,the sensitivity was 60.00%,the specificity was 83.12%,total dVRS volume in right hippocampus was AUC=0.872,the sensitivity was 80.00%,the specificity was 81.82%).Conclusion:The presence of dVRS in hippocampal structure has a certain predictive value for hippocampal atrophy in Alzheimer’s disease patients.