磁共振波谱成像对检测非痴呆型血管性认知障碍的探讨

Magnetic resonance spectroscopy in patients with vascular cognitive impairment no dementia

目的通过磁共振波谱成像技术(MRS)对非痴呆型血管认知功能障碍(VCIND)患者脑内代谢参数的测量,探讨脑内关键部位代谢改变与VCIND相关性。方法利用3.0T MRS检测VCIND患者(n=38例,VCIND组)与正常查体者(n=44例,正常对照组)在双侧额叶、颞叶、丘脑、海马、基底节及扣带回区的N-乙酰天冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值及NAA/Cr、Cho/Cr比值,比较两组优势半球的代谢改变并行统计学分析。结果与正常对照组相比,VCIND组优势半球颞叶、海马、丘脑及扣带回区NAA值和额叶、海马、丘脑、扣带回NAA/Cr比值均降低,差异有统计学意义(P<0.05);两组优势半球不同部位Cho及Cho/Cr值差异无统计学意义(P>0.05); VCIND组内优势侧与非优势侧各部位间代谢参数值差异均无统计学意义(P>0.05)。结论 NAA及NAA/Cr是检测VCIND的敏感指标,VCIND患者在脑内广泛代谢异常,但优势半球额叶、颞叶、海马、丘脑、扣带回代谢改变与VCIND密切相关。

Objective To explore the relevance between metabolic changes in the critical parts of brain and vascular cognitive impairment no dementia(VCIND)by analyzing the metabolite ratios in VCIND patients using magnetic resonance spectroscopy(MRS).Methods A total of 38 VCIND patients(VCIND group)and 44 healthy controls(control group)were involved.The N-acetyl aspartate(NAA),choline(Cho),creatine(Cr),NAA/Cr and Cho/Cr in the frontal lobe,temporal lobe,thalamus,hippocampus,basal ganglia and cingulate gyrus in the two groups were measured with 3.0 T MRS.The above parameters in dominant hemisphere of the two groups were compared and statistically analyred.Results Compared with the control group,the VCIND group had significantly reduced NAA in the temporal lobe,hippocampus,thalamus,and cingulate gyrus,and decreased NAA/Cr ratio in the frontal lobe,hippocampus,thalamus and cingulate gyrus(P<0.05).There were no statistical differences in Cho and Cho/Cr in different parts in the dominant hemisphere between two groups(P>0.05).There were no significant differences in all of the parameters between the dominant and non-dominant hemisphere in the VCIND group.Conclusion NAA and NAA/Cr are sensitive indicators to detect VCIND.VCIND patients have extensive cerebral metabolic disorder,but in the dominant hemisphere,the metabolic changes were associated with VCIND in the frontal lobe,temporal lobe,hippocampus,thalamus,and cingulate gyrus.