皮质下动脉硬化脑病MRI分型与临床分析

A Clinical Analysis and MRI typing on 86 Cases of Subcortcial Arteriosclerotic Encephaopathy

目的 :探讨皮质下动脉硬化性脑病MRI分型 ,为早期诊断及治疗提供帮助。方法 :回顾分析经MRI诊断的皮质下动脉硬化性脑病病例 86例 (男 62 ,女 2 4) ,平均年龄 80 .8岁 ,合并高血压病 72例 ,糖尿病 45例 ,腔隙性脑梗死 78例 ;根据MRI侧脑室周围白质病变范围融合程度将皮质下动脉硬化脑病分为轻、中、重型 ,并采用MMSE和ADL对每例患者的认知功能和日常生活能力进行评估。结果 :( 1)皮质下脑白质的缺血程度与年龄有一定关系 (P <0 .0 5 ) ,随着年龄的增长 ,脑白质缺血程度愈重 ,伴随高血压、糖尿病、腔隙性脑梗死患者可加重脑白质缺血。 ( 2 )认识障碍、日常生活能力与脑白质损害范围有显著相关性 (P <0 .0 0 1) ,脑白质损害范围愈大 ,认知功能障碍愈重 ,日常生活能力愈低。结论 :皮质下动脉硬化脑病发生与年龄、高血压、糖尿病、动脉粥样硬化等因素密切相关 ,早期诊断及治疗可延缓痴呆的发生 。

Objective: To explore the MRI typing of subcortical arterioscleratic encephaopathy (SAE) and provide help on and its earlier clinical diagnosis and treatment. Methods: Eighty-six cases of SAE diagnosed by MRI were analysed retrospectively. The average age were 80.8 (male 62, female 24). There were 72 cases of SAE combined with hypertension ,45 cases with diabetes and 78 cases with lancuar infarction. According to the extent and severity of lesions in periventrical white matter, SAE can be classified into three types : minor, moderate and severe. The cognitive functions of each case were also evaluated by MMSE and ADL. Results: (1) the ischemic degree in subcortical white matter were close related to age. The older the age, the more severe the ischemic degree. (2)The cognitive impairment of patients were positive related to the extent of lesions in periventrical white matter ( P <0.01). Conclusion: The occurrence of SAE are close relate to the factors such as hypertension ,diabetes ,arteriosclerosis and so on. The early diagnosis and treatment of SAE can delay the occurrence of dementia. MRI is a good method for earlier diagnosis.