基于DTI探讨慢性脑低灌注所致脑白质损伤程度与轻度认知功能障碍的相关性-现代医学

基于DTI探讨慢性脑低灌注所致脑白质损伤程度与轻度认知功能障碍的相关性

单位：1. 保定市第一中心医院神经内一科, 河北保定 071000;
2. 保定市第一中心医院内分泌实验室, 河北保定 071000;
3. 保定市第一中心医院科教科, 河北保定 071000;
4. 保定市第一中心医院内分泌一科, 河北保定 071000

关键词：脑白质认知功能血流量扩散张量成像

分类号：R445.2;R749.1

出版年·卷·期（页码）：2020·39·第四期（438-442）

摘要：

目的：探究基于磁共振弥散张量成像（DTI）的慢性脑低灌注所致脑白质损伤程度与轻度认知功能障碍的相关性。方法：选取2016年10月至2017年10月于我院接受治疗的慢性脑低灌注患者120例作为灌注组，另选取此期间于我院体检的正常人120例作为对照组。两组均行DTI后，查看影像中脑白质情况，采用Function tool软件进行影像处理，比较其表观扩散系数（ADC）值和各项异性分数（FA）值，采用GE Lightspeed 64层螺旋CT检测脑内各区域血流量及全脑血流量，采用蒙特利尔认知评估量表（MoCA）测定认知功能评分。根据Pearson相关性分析灌注组颅内的脑白质损伤程度与轻度认知功能障碍相关性。结果：灌注组侧脑室前后角脑白质周围有明显小斑块，正常组脑白质内没有发现其异常信号；灌注组枕叶、顶叶、颞叶、额叶ADC值均明显高于对照组，差异有统计学意义（P<0.05）；灌注组枕叶、顶叶、颞叶、额叶FA值明显低于对照组，差异有统计学意义（P<0.05）；灌注组脑白值受损评分显著高于对照组（P<0.05）；灌注组脑深部白质、丘脑、枕叶、顶叶、颞叶、额叶血流量均明显低于对照组，差异有统计学意义（P<0.05）；灌注组全脑血流量显著低于正常组（P<0.05）；灌注组MoCA总分明显低于对照组，差异有统计学意义（P<0.05）。全脑血流量与脑白质损伤程度呈负相关；全脑血流量与轻度认知功能障碍呈负相关；脑白质损伤与轻度认知功能障碍呈正相关。结论：全脑血流量与脑白质损伤程度及认知功能障碍评分有密切关系，其脑白质损伤程度与轻度认知功能障碍可能具有相关性。

Objective: To explore the relationship between the degree of white matter damage caused by chronic cerebral hypoperfusion and mild cognitive impairment based on diffusion tensor imaging (DTI). Methods: From October 2016 to October 2017, 120 patients with chronic cerebral hypoperfusion who were treated in our hospital were selected as the perfusion group, and another 120 normal people who were examined in our hospital as the control group. After DTI of perfusion group and control group, the white matter in the brain was examined, and the image was processed by function tool software. The ADC and FA values were compared. The blood flow in each region and the whole brain were measured by GE Lightspeed 64 slice spiral CT, and the Montreal Cognitive Assessment Scale (MoCA) was used to measure the cognitive function score. The correlation betweenthe degree of brain white matter injury in the perfusion groupand mild cognitive dysfunction by Pearson correlation analysis.Results: There were obvious small plaques around the white matter in the anterior and posterior corners of the lateral ventricles in the perfusion group, but no abnormal signal was found in the white matter in the normal group; ADC values in the occipital lobe, parietal lobe, temporal lobe and frontal lobe in the perfusion group were significantly higher than those in the control group (P<0.05); FA values in the occipital lobe, parietal lobe, temporal lobe and frontal lobe in the perfusion group were significantly lower than those in the control group (P<0.05); The blood flow of the deep white matter, thalamus, occipital lobe, parietal lobe, temporal lobe and frontal lobe in the perfusion group was significantly lower than that in the control group (P<0.05); The total blood flow of the whole brain in the perfusion group was significantly lower than that in the normal group (P<0.05); The total score of MOCA in the perfusion group was significantly lower than that in the control group (P<0.05); There was a negative correlation between the whole cerebral blood flow and the degree of brain white matter injury; There was a negative correlation between the whole cerebral blood flow and mild cognitive impairment; There was a positive correlation between the brain white matter injury and mild cognitive impairment.Conclusion: The whole cerebral blood flow is closely related to the degree of brain white matter damage and the score of cognitive dysfunction. The degree of brain white matter damage may be related to mild cognitive dysfunction.

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