MRI诊断阿尔茨海默病与血管性痴呆的价值分析

The value of MRI in the diagnosis of Alzheimer’s disease and vascular dementia

目的分析MRI诊断阿尔茨海默病(AD)与血管性痴呆(VD)的价值,为临床提供参考。方法选取2022年4月至2024年5月临沂市中心医院收治的65例AD患者纳为AD组,另选取2022年4月至2024年5月临沂市中心医院收治的65例VD患者纳为VD组,进行回顾性分析。比较两组患者MRI影像特征、MRI参数测量值、脑白质疏松(LA)严重程度与各脑叶血流参数。结果AD组患者大血管病变累及区域、小血管病变累及区域占比均低于VD组,海马萎缩占比高于VD组(均P<0.05)。AD组患者海马高度低于VD组,颞角宽度、外侧裂宽度、三脑室宽度均高于VD组(均P<0.05)。AD组患者整体LA严重程度轻于VD组(P<0.05)。AD组患者额叶、颞叶、枕叶血流水平均高于VD组(均P<0.05);两组患者顶叶血流水平比较,差异无统计学意义(P>0.05)。结论在MRI检查中,VD患者的主要特征表现为脑内存在明显的梗死灶,AD患者的主要特征表现为海马体的萎缩,两种疾病患者MRI参数测量值、LA严重程度与各脑叶血流水平均有差异。因此,MRI技术在鉴别和诊断VD与AD方面具有应用价值。

Objective To analyze the value of magnetic resonance imaging(MRI)in the diagnosis of alzheimer’s disease(AD)and vascular dementia(VD).Methods 65 AD patients admitted to Linyi Central Hospital from April 2022 to May 2024 were selected as the AD group,and another 65 VD patients admitted to Linyi Central Hospital from April 2022 to May 2024 were selected as the VD group for retrospective analysis.MRI imaging features,MRI parameters measured values,severity of leukoaraiosis(LA)and the lobes of the brain bloodflow parameters were compared between the two groups.Results The proportion of large vascular lesions involved area and small vascular lesions involved area in AD group was lower than that in VD group,and the proportion of hippocampus atrophy was higher than that in VD group(allP<0.05).The height of hippocampus in AD group was lower than that in VD group,and the width of temporal Angle,lateral cleft width and third ventricle width were higher than those in VD group(allP<0.05).The overall severity of LA in AD group was less than that in VD group(P<0.05).The bloodflow levels of frontal,temporal and occipital lobes in AD group were higher than those in VD group(allP<0.05).There was no significant difference in parietal lobe bloodflow between two groups(P>0.05).Conclusion In MRI examination,the main feature of VD patients is the presence of a significant infarction lesion in the brain,and the feature of AD is hippocampal atrophy.There are differences between the two diseases in MRI parameter measurements,LA severity and bloodflow level of each cerebral lobe.Therefore,MRI technology has application value in the differentiation and diagnosis of VD and AD.