摘要
目的集中对脑梗死患者脑微结构异常的多模态磁共振成像(MRI)与认知功能的相关性进行分析。方法100例脑梗死患者,采用蒙特利尔认知评估量表(MoCA)评分分成认知损害组(n=58)以及认知未损害组(n=42)。两组患者均进行多模态MRI以及认知功能评估。对比两组患者的主要认知功能[简易精神状态评价量表(MMSE)、临床痴呆评定量表(CDR)、日常生活活动能力量表(ADL)、Hachinski缺血量表(HIS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)]及其他认知功能[听觉言语学习测验(AVLT)、数字广度测验(DST)、执行功能和信息处理能力(IPS)、连线测试A(TMT-A)、Boston命名测验(BNT)]评分,扩散参数情况(各向异性分数、平均扩散率、轴向扩散率、径向扩散率);分析扩散参数与认知功能障碍的相关性。结果认知损害组的MMSE、ADL、HIS评分分别为(22.51±2.84)、(50.29±6.84)、(7.86±2.15)分,均低于认知未损害组的(26.51±3.18)、(62.94±7.56)、(11.23±3.24)分,CDR、HAMD及HAMA评分分别为(1.87±0.29)、(31.94±4.67)、(30.15±3.51)分,均高于认知未损害组的(1.45±0.22)、(26.48±3.52)、(24.57±3.24)分(P<0.05)。认知损害组的AVLT、DST、IPS、TMT-A、BNT评分分别为(2.42±0.39)、(2.19±0.56)、(2.98±0.61)、(2.32±0.42)、(2.49±0.32)分,均低于认知未损害组的(3.09±0.51)、(3.09±0.57)、(3.88±0.67)、(3.09±0.45)、(3.16±0.44)分(P<0.05)。认知损害组的各向异性分数(7.12±1.21)分、平均扩散率(53.28±5.82)μm^(2)/ms、轴向扩散率(43.15±5.62)μm^(2)/ms、径向扩散率(49.85±5.84)μm^(2)/ms均高于认知未损害组的(5.82±0.97)分、(49.59±5.27)μm^(2)/ms、(36.15±4.84)μm^(2)/ms、(42.51±4.72)μm^(2)/ms,(P<0.05)。Pearson相关性分析显示,各向异性分数、平均扩散率、轴向扩散率、径向扩散率与脑梗死患者的认知功能障碍呈正相关(P<0.05)。结论对存在认知功能障碍的脑梗死患者采取多模态MRI检查能够有效识别患者的脑微结构异常,以为临床对该异常实施早期干预提供依据。
Objective To analyze the correlation between multimodal magnetic resonance imaging(MRI)of cerebral microstructural abnormalities and cognitive function in patients with cerebral infarction.Methods 100 patients with cerebral infarction were divided into cognitive dysfunction group(n=58)and noncognitive dysfunction group(n=42)using the Montreal cognitive assessment(MoCA)score.Both groups underwent multimodal MRI and cognitive function assessment.Both groups were compared in terms of main cognitive functions[Mini Mental State Examination(MMSE),Clinical Dementia Rating Scale(CDR),Activities of Daily Living Scale(ADL),Hachinski Ischemia Scale(HIS),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)]and other cognitive functions[Auditory-Verbal Learning Test(AVLT),Digital Span Test(DST),Information Processing Speed(IPS),TMT Part A(TMT-A),Boston Naming Test(BNT)],diffusion parameters(fractional anisotropy,mean diffusivity,axial diffusivity,radial diffusivity);the correlation of diffusion parameters and cognitive dysfunction was analyzed.Results The scores of MMSE,ADL and HIS in the cognitive dysfunction group were(22.51±2.84),(50.29±6.84)and(7.86±2.15)points,which were lower than(26.51±3.18),(62.94±7.56)and(11.23±3.24)points in the non-cognitive dysfunction group;the scores of CDR,HAMD and HAMA in the cognitive dysfunction group were(1.87±0.29),(31.94±4.67)and(30.15±3.51)points,which were higher than(1.45±0.22),(26.48±3.52)and(24.57±3.24)points in the non-cognitive dysfunction group(P<0.05).The scores of AVLT,DST,IPS,MTT-A and BNT in the cognitive dysfunction group were(2.42±0.39),(2.19±0.56),(2.98±0.61),(2.32±0.42)and(2.49±0.32)points,which were lower than(3.09±0.51),(3.09±0.57),(3.88±0.67),(3.09±0.45)and(3.16±0.44)points in the non-cognitive dysfunction group(P<0.05).The fractional anisotropy,mean diffusivity,axial diffusivity and radial diffusivity in the cognitive dysfunction group were(7.12±1.21)μm^(2)/ms,(53.28±5.82)μm^(2)/ms,(43.15±5.62)μm^(2)/ms and(49.85±5.84)μm^(2)/ms,which were higher than(5.82±0.97)μm^(2)/ms,(49.59±5.27)μm^(2)/ms,(36.15±4.84)μm^(2)/ms and(42.51±4.72)μm^(2)/ms in the non-cognitive dysfunction group(P<0.05).Pearson correlation analysis showed that fractional anisotropy,mean diffusivity,axial diffusivity,radial diffusivity were positively correlated with cognitive dysfunction in patients with cerebral infarction(P<0.05).Conclusion Multimodal MRI examination of cerebral infarction patients with cognitive dysfunction can effectively identify the cerebral microstructural abnormalities,and provide a basis for early clinical intervention of this abnormality.
作者
卢翠玲
周海强
钟敏仪
黄敏仪
LU Cui-ling;ZHOU Hai-qiang;ZHONG Min-yi(Department of Neurology,Dalang Hospital,Dongguan 523777,China)
出处
《中国实用医药》
2025年第2期65-69,共5页
China Practical Medicine
基金
东莞市社会发展科技局项目(编号项目:20211800901552),项目名称:脑梗死患者脑微结构异常的多模态MRI与认知功能的相关性研究。
关键词
脑梗死
脑微结构异常
多模态磁共振成像
认知功能
相关性
Cerebral infarction
Cerebral microstructural abnormalities
Multimodal magnetic resonance imaging
Cognitive function
Correlation
