合成MRI技术及海马体积测量联合MMSE评分对轻度血管性认知障碍患者早期筛查的价值

Value of synthetic MRI and hippocampus volume measurement combined with Mini-Mental Status Examination (MMSE) score in early screening of patients with mild vascular cognitive impairment

目的 探讨合成MRI技术(MAGiC序列)测量海马整体T1值、T2值、R1值、R2值及海马体积(HV)测量联合简易智力状况检查量表(MMSE)评分对轻度血管性认知障碍(mVCI)患者评估的价值。方法 回顾性收集新疆医科大学第一附属医院神经内科61例因缺血性脑卒中(IS)入院的患者,其中mVCI患者30例为mVCI组,未出现认知障碍患者31例为对照组,收集两组患者合成MRI技术处理得到的双侧海马整体量化数值(T1值、T2值、R1值、R2值),通过T1-MPRAGE后处理得到双侧海马体积(HV),MMSE评分。比较两组患者上述参数的差异,以及各影响因素对mVCI的预测能力。结果 mVCI组和对照组平均年龄和受教育程度对认知障碍的影响差异具有统计学意义(P均<0.05),mVCI组MMSE评分明显低于对照组(P<0.05)。mVCI组和对照组左侧和右侧海马整体的T1值、T2值、R1值、R2值比较,T1值、R1值差异有统计学意义(P<0.05),有认知障碍患者的T1值大于未出现认知障碍患者,R1值小于未出现认知障碍患者。两组双侧海马体积变化差异无统计学意义(P>0.05)。双侧海马整体T1值、R1值预测mVCI的最佳节点为左侧T1值1 319.50,R1值0.795;右侧T1值为1 305.50,R1值0.785,MMSE评分有效节点为23分(含23分),其特异度在本研究中为100%。结论 MAGiC序列分析mVCI患者双侧海马整体T1值、R1值的改变联合MMSE评分可为临床评估IS患者是否出现认知障碍症状提供预测,以及为早期筛查提供有价值的信息。HV对mVCI诊断的价值无统计学意义。

Objective To evaluate the value of synthetic MRI(MAGiC sequence)measurements of hippocampus T1,T2,R1,R2 and hippocampus volume(HV)combined with Mini-Mental Status Examination(MMSE)score in patients with mild vascular cognitive impairment(mVCI).Methods61 patients with ischemic stroke(IS)admitted to the hospital were retrospectively collected,of which 30 patients with mVCI were selected as mVCI group,and 31 patients without cognitive impairment were selected as control group.The global quantitative values(T1 value,T2 value,R1 value and R2 value)of the bilateral hippocampus processed by synthetic MRI technology were collected from the two groups,and the bilateral hippocampal volume(HV)and MMSE score were obtained by T1-MPRAGE post-treatment.The differences of the above parameters and the predictive ability of each influencing factor on mVCI were compared between the two groups.ResultsThe difference in the impact of average age and education level on cognitive impairment between mVCI group and control group was statistically significant(P<0.05),and the MMSE score of the mVCI group was significantly lower than that of the control group(P<0.05).There were statistically significant differences in T1 and R1 values between the left and right hippocampus of mVCI group and control group(P<0.05).The T1 value of the patients with cognitive impairment was higher than that of the patients without cognitive impairment,and the R1 value was lower than that of the patients without cognitive impairment.There was no significant difference in the volume change of bilateral hippocampus between the two groups(P>0.05).The optimal node for predicting mVCI based on the overall T1 and R1 values of the bilateral hippocampus was the left T1 value of 1319.50 and the R1 value of 0.795.The T1 value on the right was 1305.50,the R1 value was 0.785,and the effective node of MMSE score was 23 points(including 23 points),its specificity is 100%in this study.ConclusionMAGiC sequence analysis of the changes of T1 and R1 values of bilateral hippocampus in mVCI patients combined with MMSE score can provide valuable information for clinical assessment of the cognitive impairment symptoms and early screening of IS patients.The diagnostic value of HV for mVCI is not statistically significant.