摘要
目的对比血管损伤与脑萎缩在阿尔茨海默病(AD)、血管性痴呆(VD)或混合性痴呆(MD)患者中的分布,探究MRI在AD、VD、MD鉴别诊断中的价值。方法76例患者分别诊断为AD34例、VD31例和MD 22例。分别对三组通过分析MRI图像进行独立视觉评分量表和Evans's指数评估。结果与AD相比,MD的脑室周围白质病变PVL(P=0.002)、深部白质病变DWML(P=0.006)、皮质下微出血Juxtacortical MB(P=0.007)、深部白质微出血Deep MB(P=0.003)评分更高,VD的深部灰质病变DGML(p=0.016)、血管周围间隙PVS BG-CS(P=0.005)明显更多。VD与MD比较,血管性病变视觉评分结果无统计学差异,但VD患者内侧颞叶萎缩MTA(P<0.001)评分显著高于MD。脑皮层萎缩和Evans's指数的分布在组间无显著差异。结论MRI在痴呆患者的评估中可以更准确地检测血管病变及评估脑萎缩情况。研究证实血管病变在VD或MD患者中比AD更多,其中MD以深部和皮层旁微出血为主,这表明淀粉样脑血管病(CAA)可能是其主要的潜在病理机制。
Objective The study aims to investigate their distribution in patients with Alzheimer's,vascular or mixed dementia and detect any distinctive neuroradiological profiles.Methods Seventy-six subjects received a diagnosis of Alzheimer’s(AD=34),vascular(VD=31)and mixed(MD=22)dementia.Three independent raters assessed the brain images acquired with 3T MRI protocol using semiquantitative scales for vascular lesions.Results A greater number of PVL(P=0.002)、[]DWML(P=0.006)、Juxtacortical MB(P=0.007)、Deep MB(P=0.003)was observed in MD compared to AD,while VD showed a significant greater number of DGML(P=0.016)、PVS BG-CS(P=0.005).Comparing VD and MD,No significant difference was observed in Vascular Lesions,but VD showed a higher number of MTA(P<0.001).No significant difference was observed in scores of cortical atrophy scales and Evans index among the three groups.Conclusion The proposed MRI protocol represents a useful advancement in the diagnostic assessment of patients with cognitive impairment by more accurately detecting vascular lesions,mainly microbleeds,without a significant increase in time and resource expenditure.Our findings confirm that white and grey matter lesions predominate in vascular and mixed dementia,whereas deep and juxtacortical microbleeds predominate in mixed dementia,suggesting that cerebral amyloid angiopathy could be the main underlying pathology.
作者
陈昱
陈大才
陈薪宇
毕娟娟
简薇
徐丽丝
CHEN Yu;CHEN Da-cai;CHEN Xin-yu;BI Juan-juan;JIAN Wei;XU Li-si(Department of Radiology,The Fourth People's Hospital of Chengdu,Chengdu 610000,SichuanProvice,China;Department of Cardiovascular Medicine,The Fourth People's Hospital of Chengdu,Chengdu;610000,Sichuan Provice,China 3.Department of Gerontology,The Fourth People's Hospital of Chengdu,Chengdu 610000,Sichuan Provice,China)
出处
《中国CT和MRI杂志》
2024年第2期18-21,共4页
Chinese Journal of CT and MRI
基金
2021年成都市医学科研课题(2021301)。
