[1]张 强,袁 婕,董晓云,等.磁共振弥散张量成像在无症状性腔隙性脑梗死患者认知障碍中的应用研究[J].陕西医学杂志,2023,52(1):57-61.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.013]
 ZHANG Qiang,YUAN Jie,DONG Xiaoyun,et al.Application of diffusion tensor imaging in cognitive impairment of patients with asymptomatic lacunar infarction[J].,2023,52(1):57-61.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.013]
点击复制

磁共振弥散张量成像在无症状性腔隙性脑梗死患者认知障碍中的应用研究
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年1期
页码:
57-61
栏目:
临床研究
出版日期:
2023-01-05

文章信息/Info

Title:
Application of diffusion tensor imaging in cognitive impairment of patients with asymptomatic lacunar infarction
作者:
张 强1袁 婕1董晓云1张 虹1崔小丽1王亚奎2
(1.陕西省人民医院神经内一科,陕西 西安 710068; 2.韩城市人民医院影像科,陕西 韩城 715400 )
Author(s):
ZHANG QiangYUAN JieDONG XiaoyunZHANG HongCUI XiaoliWANG Yakui
(The First Department of Neurology,Shaanxi Provincial People's Hospital,Xi'an 710068,China)
关键词:
无症状性脑梗死 认知障碍 弥散张量成像 脑白质 表观弥散系数 各向异性分数
Keywords:
Asymptomatic cerebral infarction Cognitive impairment Diffusion tensor imaging White matter of bruin Apparent diffusion coefficient Fractional anisotropy
分类号:
R 743
DOI:
DOI:10.3969/j.issn.1000-7377.2023.01.013
文献标志码:
A
摘要:
目的:利用磁共振弥散张量成像(DTI)探讨合并认知障碍的无症状性脑梗死患者脑白质结构改变特点。方法:收治住院的28例无症状性腔隙性脑梗死不伴脑白质病变患者,按照蒙特利尔认知评估表(MoCA)大于等于26分分为认知正常组和认知障碍组,住院期间行头颅DTI检查,利用基于兴趣区(ROI)分析方法,测量两组患者同一水平、镜面对称的双侧侧脑室前角、后角、侧脑室体旁、半卵圆中心近腹侧、半卵圆中心近背侧看似正常脑白质的表观弥散系数(ADC)和各向异性分数(FA)值。结果:认知正常组与认知障碍组在右侧侧脑室前角、双侧侧脑室后角、双侧侧脑室体旁、双侧半卵圆中心近腹侧、双侧半卵圆中心近背侧ADC值比较无统计学差异(均P>0.05),但是左侧侧脑室前角ADC值比较差异有统计学意义(P<0.05)。认知正常组与认知障碍组在右侧侧脑室前角、右侧侧脑室后角、左侧侧脑室体旁、左侧半卵圆中心近背侧FA值比较差异无统计学意义(均P>0.05),两组患者在左侧侧脑室前角、左侧侧脑室后角、右侧侧脑室旁、双层半卵圆中心近腹侧、右侧半卵圆中心近背侧FA比较值差异存在统计学意义(均P<0.05)。结论:无症状性脑梗死患者的认知损害,多表现在执行功能、注意力、语言流畅性; 左侧侧脑室前角、左侧侧脑室后角、右侧侧脑室旁、双层半卵圆中心近腹侧、右侧半卵圆中心近背侧的白质纤维参与了多个认知域的形成。
Abstract:
Objective:To study the characteristics of white matter structure changes in asymptomatic cerebral infarction patients with cognitive impairment by using diffusion tensor imaging(DTI).Methods:The clinical data and DTI parameter of 38 patients with asymptomatic lacunar infarction without white matter lesions were collected retrospectively.These patients were divided into cognitive normal group(MoCA score more than or equal to 26)and cognitive impaired group(MoCA score less than 26).Head DTI was performed in both groups during the hospitalization.Based on the Region-of-interest(ROI)analysis method,the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)values were measured in the following mirror-symmetrical areas with the same level:bilateral anterior horns of lateral ventricles,bilateral posterior horns of lateral ventricles,body of lateral cerebral para-ventricle,bilateral ventral parts of centrum oval,bilateral dorsal parts of centrum oval.Results:There was no statistically significant difference in ADC values between the two groups in right anterior horn of lateral ventricle,bilateral posterior horns of lateral ventricles,bilateral bodies of lateral cerebral para-ventricle,bilateral ventral and dorsal parts of centrum oval(all P>0.05),while the ADC value of anterior horn of right lateral ventricle was significantly different(P<0.05).Significant differences in FA values existed in the anterior horn of left lateral ventricle,the posterior horn of the left lateral ventricle,the body of right lateral cerebral para-ventricle,bilateral ventricle parts of centrum oval and the right dorsal part of centrum oval between the two groups(all P<0.05),while there was no statistically significant difference in FA value in the anterior horn of right lateral ventricle,the posterior horn fo the right lateral ventricle,the body of left lateral cerebral para-ventricle and the left dorsal part of centrum oval(all P>0.05).Conclusion:Cognitive impairment in patients with asymptomatic cerebral infarction is mostly manifested in executive function,attention,and language fluency.The white matter fibers of the anterior horn of left lateral ventricle,the posterior horn of left lateral ventricle,the body of right lateral cerebral para-ventricle,the bilateral ventricle parts of centrum oval and right dorsal of centrum oval are involved in the formation of multiple cognitive domains.

参考文献/References:

[1] Fanning JP,Wong AA,Fraser JF.The epidemiology of silent brain infarction:A systematic review of population-based cohorts[J].BMC Med,2014,12:119.
[2] Thong JY,Hilal S,Wang Y,et al.Association of silent lacunar infarct with brain atrophy and cognitive impairment[J].J Neurol Neurosurg Psychiatry,2013,84(11):1219-1225.
[3] 吴向菊,张春梅.无症状性脑梗死的临床研究现状[J].中国医药导报,2017,14(21):57-60.
[4] 杨 升,普晓慧,艾青龙.无症状脑梗死与认知功能障碍临床诊疗进展[J].中国医学创新,2020,17(21):165-169.
[5] Koga H,Takashima Y,Murakawa R,et al.Cognitive consequences of multiple lacunes and leukoaraiosis as vascular cognitive impairment in community-dwelling elderly individuals[J].J Stroke Cerebrovasc Dis,2009,18(1):32-37.
[6] Tuladhar AM,Van-Norden AG,De-Laat KF,et al.White matter integrity in small vessel disease is related to cognition[J].Neuroimage Clin,2015,7:518-524.
[7] Marmarelis VZ,Shin DC,Tarumi T,et al.Comparing model-based cerebrovascular physiomarkers with DTI biomarkers in MCI patients[J].Brain Behav,2019,9(8):e1356.
[8] 段晓迪,董彬彬,邓丽君,等.血管性认知障碍患者小脑白质纤维束改变的临床研究[J].中华老年心脑血管病杂志,2021,23(4):394-398.
[9] 井 泉,蒲秀玲,李明娥.无症状性脑梗死58例临床分析[J].陕西医学杂志,2007,36(3):318-319.
[10] 刘晓东,臧 琳,郭婷婷,等.无症状脑梗死危险因素的研究进展[J].临床神经病学杂志,2020,33(5):386-389.
[11] Hu HY,Ou YN,Shen XN,et al.White matter hyperintensities and risks of cognitive impairment and dementia:A systematic review and meta-analysis of 36 prospective studies[J].Neurosci Biobehav Rev,2021,120:16-27.
[12] Langen CD,Cremers L,De-Groot M,et al.Disconnection due to white matter hyperintensities is associated with lower cognitive scores[J].Neuroimage,2018,183:745-756.
[13] Liao Z,Dang C,Li M,et al.Microstructural damage of normal-appearing white matter in subcortical ischemic vascular dementia is associated with montreal cognitive assessment scores[J].J Int Med Res,2019,47(11):5723-5731.
[14] Eftekhari E,Hojjat SP,Vitorino R,et al.Normal appearing white matter permeability:A marker of inflammation and information processing speed deficit among relapsing remitting multiple sclerosis patients[J].Neuroradiology,2017,59(8):771-780.
[15] Dao E,Tam R,Hsiung GR,et al.Exploring the contribution of myelin content in normal appearing white matter to cognitive outcomes in cerebral small vessel disease[J].J Alzheimers Dis,2021,80(1):91-101.
[16] Khan W,Khlif MS,Mito R,et al.Investigating the microstructural properties of Normal-Appearing White Matter(NAWM)preceding conversion to White Matter Hyperintensities(WMHs)in stroke survivors[J].Neuroimage,2021,232:117839.
[17] 李棠华,潘金万,卢顺钱.磁共振弥散张量和波谱成像在缺血性脑小血管疾病中的应用研究[J].现代医用影像学,2020,29:485-487.
[18] 罗梦婷,王建波,王 丹,等.老年抑郁症DTI和TDI研究[J].中国医学计算机成像杂志,2017,23(4):308-313.
[19] 李 华,纪文军,陈 轶,等.磁共振扩散张量成像(DTI)对轴索损伤患者动态监测研究[J].陕西医学杂志,2016,45(3):332-334.
[20] 资文杰.侧脑室旁白质变性患者认知损害特征及磁共振弥散张量成像研究[D].重庆:第三军医大学,2014.
[21] Bosch B,Arenaza-Urquijo EM,Rami L,et al.Multiple DTI index analysis in normal aging,amnestic MCI and AD.relationship with neuropsychological performance[J].Neurobiol Aging,2012,33(1):61-74.
[22] 丁辉燕.复方苁蓉益智胶囊联合奥拉西坦治疗脑白质疏松认知障碍疗效观察[J].陕西中医,2017,38(8):991-992.

相似文献/References:

[1]高 林,闵连秋△.磁共振质子波谱成像在卒中后认知障碍研究中的应用*[J].陕西医学杂志,2020,49(7):792.[doi:DOI:10.3969/j.issn.10007377.2020.07.006]
 GAO Lin,MIN Lianqiu..Clinical significance of proton magnetic resonance spectroscopy in the study of cognitive impairment after stroke[J].,2020,49(1):792.[doi:DOI:10.3969/j.issn.10007377.2020.07.006]
[2]赵阿敏,黄晓波.阻塞性睡眠呼吸暂停低通气综合征患者认知功能障碍及相关影响因素分析[J].陕西医学杂志,2020,49(8):955.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.011]
[3]陈金权,赵 娟.右美托咪定对缺血性脑损伤大鼠神经功能及认知障碍恢复的影响研究[J].陕西医学杂志,2022,51(2):155.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.006]
 CHEN Jinquan,ZHAO Juan.Effects of dexmedetomidine on recovery of neurological function and cognitive impairment in rats with ischemic brain injury[J].,2022,51(1):155.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.006]
[4]刘 剑,陈 亮.Tau蛋白、胶质纤维酸性蛋白在创伤性颅脑损伤程度不同患者中的表达及其与患者认知障碍相关性研究[J].陕西医学杂志,2023,52(4):452.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.020]
 LIU Jian,CHEN Liang.Expression of Tau and glial fibrillary acidic protein in patients with different degrees of traumatic brain injury and their correlation with cognitive impairment[J].,2023,52(1):452.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.020]
[5]王俐慧,苏东风,隋汝波.脑小血管病患者血清甲壳质酶蛋白40、视锥蛋白样蛋白1表达特征及与认知障碍相关性研究[J].陕西医学杂志,2023,52(8):1038.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.022]
 WANG Lihui,SU Dongfeng,SUI Rubo.Expression characteristics of YKL-40 and VILIP-1 in serum and their relationship with cognitive impairment in patients of cerebrovascular disease[J].,2023,52(1):1038.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.022]
[6]张苗苗,乔 伟,李虹霖,等.重复经颅磁刺激疗法治疗卒中后认知障碍研究进展[J].陕西医学杂志,2024,(4):561.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.028]
[7]申倩伟,马迎春,李 倩,等.乙酰谷酰胺对创伤性颅脑损伤大鼠的作用及机制实验研究[J].陕西医学杂志,2025,54(2):187.[doi:DOI:10.3969/j.issn.1000-7377.2025.02.008]
 SHEN Qianwei,MA Yingchun,LI Qian,et al.Effect and mechanism of acetylglutamine on traumatic brain injury in rats[J].,2025,54(1):187.[doi:DOI:10.3969/j.issn.1000-7377.2025.02.008]

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2021JQ-903)
更新日期/Last Update: 2022-12-28