【摘要】 目的探讨基于3T磁敏感加权图像(SWI)对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者脑内微小低信号病灶(SHF)的发病率和分布图的分析,用于早期MCI的诊断及与AD的鉴别。方法对临床拟诊为MCI的病例36例和40例AD患者进行3T-SWI检查,并对所有患者进行简易精神状态检查表(MMSE)评分。2名高年资神经放射医师评价SWI相位图上SHF的数目和位置。部位包括脑叶(额颞顶枕叶)、基底节区/丘脑、脑干/小脑三个区域,并与MMSE评分进行统计相关分析。结果二组患者在年龄、性别及受教育程度方面无明显统计学差异(P值>0.05)。SHF病灶以脑叶多见,其次基底节区/丘脑和脑干/丘脑。三类不同脑区的SHF的发病率在MCI和AD组间具有显著性差异(P值<0.05)。MMSE的评分MCI为22±1.2,AD评分为18±1.5。且二组间MMSE存在统计学差异(P值<0.05);3类不同区域间SHF发生率与MMSE呈负相关(r=-0.36,P<0.05)。结论 3T-SWI成像技术简单,无创,安全可重复,易于检出异常SHF,可用于MCI的早期诊断和AD进展期的预测。更多还原

【Abstract】 Objective To compare the difference of brain small hypointense foci(SHF)between mild cognitive impairment(MCl)patients and Alzheimer’s disease(AD)patients by applying SWI.Methods 36 MCI patients and 40 AD patients were collected from Nanjing Brain Hospital.SWI examination was performed and evaluated the MMSE scores.Two senior neuroradiologists assessed the number and location of SHF on 2mm contiguous SWI.They reviewed divergent evaluations to reach a consensus.The location of SHF included lobar regions(frontal,temporal,parietal,and occipitall lobe),basal ganglia/thalamus,and infratentorial regions(brain stem and cerebellum).We evaluated the cerebral significance of phase value difference,ages,sex,education,and MMSE between MCI and AD.The correlation of SHF number and MMSE score was analyzed by Bonferroni correlation.Results There were no differences in age,sex and education betweem the MCI and AD group.(P >0.05),while there were statistically differences of SHF in lobar regions,basal ganglia/thalamus,and infratentorial regions(brain stem and cerebellum)on SWI images(P <0.05).The lobar region was the most frequent site of SHF in the two groups,then in basal ganglia/thalamus,and brain stem/cerebellum.The MMSE score of MCI was 22±1.2,18±1.5for AD.Statistical significance was among the three regions.and scores for MCI and AD.Positive Bonferroni correlations were also measured between SHF numbers and MMSE scores(r =-0.36,P <0.05).Conclusion 3TSWl was a simple,safe and non-invasive method and had good repeatability.The SHF in MCI and AD patients could be distinguished by SWI.SWI may provide a new noninvasive dynamic monitoring method and valuable biological indicator for the early diagnosis of AD and MCI and the prevention of developing from MCI to AD.更多还原