【作者】 王芳；

【导师】 刘进才；

【作者基本信息】 南华大学 ， 临床医学（影像医学与核医学）（专业学位）， 2016， 硕士

【摘要】 目的:多种脑部结构变化与老龄化脑及2型糖尿病脑相关。本研究旨在探讨基于磁共振检查的脑萎缩及病变指数(brain atrophy and lesion index,BALI)评分对糖尿病脑轻度认知障碍的预测性能。材料与方法:本研究按顺序选取2014年1月至2016年1月就诊于本院且资料完整的患者88例。收集患者的一般临床资料,并进行Mo CA(Montreal Cognitive Assessment,Mo CA)及MMSE(Mini-Mental State Examination,MMSE)认知评分,根据MMSE评分分为轻度认知障碍组及认知正常组。所有受试者均进行高分辨3.0T磁共振成像检查。根据BALI进行影像学评分。不同认知组间的BALI总分及其子分类评分均数的组间比较采用单因素方差分析。采用非参数检验方法检测不同认知组及有无糖尿病组的人口统计学特性,采用Pearson相关系数评估BALI及子分类评分与年龄及MMSE评分之间的关系,采用Spearman相关系数分析BALI评分与认知水平的相关性,观察不同图像类型BALI总分与年龄之间的相关性。绘制ROC图及计算灵敏度、特异度评估BALI预测性能。结果:(1)本数据的所有受试者的T1WI BALI及T2WI BALI评分呈明显线性相关(r=0.93,P<0.001)。(2)在不同认知组间,轻度认知障碍组BALI总分及所有子分类评分均数均高于认知正常组,且除了BG、IT以外其它子分类之间具有统计学差异,不同认知组的性别及受教育程度没有统计学差异,但是Mo CA评分及年龄具有相关性(P<0.05),糖尿病组及非糖尿病组的认知评分及BALI评分之间具有统计学差异。不同类型图像的BALI总分与年龄具有相关性(r=0.516,P<0.001)。T1WI及T2WI BALI评分的特异度分别为:81.5%、66.2%,灵敏度分别为56.5%、69.6%。受试者工作特征曲线下面积分别为0.71(T1WI)、0.72(T2WI)。结论:多种脑部结构变化对认知功能有叠加影响且能被BALI总分综合评估。BALI评分有预测糖尿病脑轻度认知功能障碍的潜能。更多还原

【Abstract】 Objective: a variety of brain structural changes associated with aging and type 2 diabetes mellitus. The purpose of this study is to explore the performance of brain atrophy and lesions index in predict of mild cognitive impairment in type 2 diabetes mellitus.Materials and Methods: This study sequentially collected 88 cases in our hospital outpatient and inpatient department from January 2014 to January 2016. The clinical data of patients been collected, All patients carry out Mo CA and MMSE cognitive scoring, and according to the MMSE scores to divided patients into mild cognitive impairment group(n=23) and cognitive normal group(n=65). All patients were finished high resolution 3.0T magnetic resonance imaging scan.Comparisons of the mean values of the BALI total scores and the sub-scores by diagnostic groups conducted using one-way ANOVA.Using nonparametric test to detect cognitive demographic characteristics of different groups and the presence of diabetes group. Pearson correlation coefficient to assess the relationship between BALI scores and age, MMSE scores. Using Spearman correlation coefficient to detect the relationship between BALI scores and diagnostic groups. Receiver operating characteristic analysis(ROC) and Sensitivity analysis was used to examine the performance of BALI.Results: T1 WI and T2 WI based BALI scores showed a linear correlation(r = 0.93, P <0.001). The mean values of BALI total scores and sub-scores of mild cognitive impairment group were higher than control group, and except for BG, IT group, other sub-scores have statistically difference. Sex and education degree have no statistically difference between diagnostic groups, but Mo CA scores and age have statistically difference(P<0.05). cognitive scores and BALI scores have statistically difference between diabetic and non-diabetic group. Different types of images BALI scores correlated with age(r = 0.516, P <0.001).Specificity of T1 WI and T2 WI based BALI scores were 81.5%, and66.2%, Sensitivity were 56.5%, 69.6%. The area under the ROC curve was 0.71(T1WI), 0.72(T2WI).Conclusion: Multiple structural changes in brain have an additive effect on cognition and can be collectively evaluated by use of the BALI total score. BALI scores have potentiality for predict mild cognitive impairment in type 2 diabetes mellitus.更多还原