天津医药

• 论著 •    

老年痴呆患者脑白质结构的扩散加权成像研究

冯丽莎   

  1. 天津医科大学第二医院
  • 收稿日期:2009-12-18 修回日期:2009-12-26 出版日期:2010-03-15 发布日期:2010-03-15
  • 通讯作者: 冯丽莎

The cerebral white matter in the Alzheimer’s disease in diffusion weighted imaging study

  • Received:2009-12-18 Revised:2009-12-26 Published:2010-03-15 Online:2010-03-15

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摘要： 目的 应用扩散加权成像(diffusion weighted imaging，DWI)阐明阿尔茨海默病（AD）脑白质微结构平均弥散系数(ADC)的变化，进一步探讨脑白质微结构改变与认知功能损害之间的关系。方法 选取AD组及对照组各30例。所有受检者均进行神经科查体和简易智能精神状态量表(MMSE)测试，对常规脑部MRI脑白质表现正常的部位行DWI检查，测量不同兴趣区的平均弥散系数（ADC），选择额叶白质、颞叶白质、顶叶白质、枕叶白质、胼胝体膝部、胼胝体压部5个兴趣区，定量测量ADC值。结果老年痴呆组ADC值与对照组比较，在额叶白质(ADC：t=-0.050，p<0.01)、胼胝体膝部(ADC：t=-0.012,p>O.05)、胼胝体压部(ADC：t=-0.028，p<0.05)、颞叶(ADC：t=-0.062，p<0.01)、顶叶(ADC：t=-0.057，p<0.01)、枕叶(ADC：t=0.000，p>0.05)。老年痴呆组顶叶白质、胼胝体压部、额叶白质的ADC值与简易智能精神状态量表(MMSE)相关，尤其是顶叶白质的ADC值相关更显著(r=-0.867，p<0.01)。结论 老年痴呆的定量DWI分析，有助于评价AD常规MRI检查正常区域的微结构改变。顶叶脑白质ADC值的异常在认知功能损害早期更明显，DWI功能与结构的结合，表明老年痴呆认知功能的衰退与白质微结构密切相关。

关键词: 磁共振成像, 老年, 痴呆, 弥散

Abstract: Objective To elucidate the changes in apparent diffusion coefficients (ADC) by quantify diffusion weighted (DW)magnetic resonance imaging (MRI)in the Alzheimer’s disease(AD). Methods DW MRI was performed in 30 probable AD patients and 30-normal controls with normal –appearing white matter (NAWM) was studied using 1.5 T MR system . apparent diffusion coefficients (ADC) were measured in different WM areas. Subjects were examined by neurologic and neuropsychological assessment with mini-mental state examination(MMSE).ADC were determined in standard regions of the frontal ，temporal ，occipital and parietal white matter ,genu , splenium of the corpus callosum . Results on DWI, there was no significant difference in the values of ADC between male and female, or between the right and left hemisphere (all p>0.05),the valuea of AD :frontal(ADC：t=-0.050，p<0.01)、parietal (ADC：t=-0.057，p<0.01)、genu of the corpus callosum (ADC：t=-0.012,p>O.05)、splenium (ADC：t=-0.028，p<0.05)、temporal(ADC：t=-0.062，p<0.01)、occipital(ADC：t=0.000，p>0.05). AD patients , ADC of splenium of the corpus callosum , parietal，frontal white matter, correlated significantly with MMSE scores. Especially parietal. Conclusion Quantitative DWI analysis may be helpful in assessing MRI DWI can detect WM abnormalities in AD ．The parietal WM abnormalities may play an important role in the development of dementia．The combination of function and structure of MRI, indicating that Alzheimer's cognitive decline and white matter closely related concept of micro-structure.

Key words: Magnetic resonance imaging, aging, dementia, diffusion