摘要
目的探讨深髓静脉评分联合MRI负担评分对老年脑小血管病(CSVD)患者血管性认知障碍(VIC)的诊断价值。方法选取188例老年CSVD患者,采用MMSE量表进行VIC诊断,根据是否并发VIC,分为VIC组(123例)和非VIC组(65例);根据蒙特利尔认知量表(MoCA)评分将VIC组分为非重度VIC组(91例)和重度VIC组(32例)。所有患者均接受头颅MRI检查,计算深髓静脉评分和MRI负担评分,使用多因素Logistic回归分析VIC的影响因素,绘制受试者工作特征曲线(ROC)分析深髓静脉评分和MRI负担评分对VIC的诊断效能。结果VIC组与非VIC组在年龄、吸烟史、既往卒中史、高血压、糖尿病、高脂血症、空腹血糖、总胆固醇、深髓静脉评分和MRI负担评分等差异均有统计学意义(P<0.05);高血压、糖尿病、高脂血症、深髓静脉评分和MRI负担评分均是VIC的独立危险因素(P<0.05);深髓静脉评分、MRI负担评分均与MMSE评分、MoCA评分呈正相关(P<0.05);重度VIC组深髓静脉评分、MRI负担评分均高于非重度VIC组,差异有统计学意义(P<0.05);深髓静脉评分联合MRI负担评分诊断VIC的敏感度为88.76%、特异度为51.32%、曲线下面积(AUC)为0.917。结论深髓静脉评分和MRI负担评分与老年CSVD患者的认知功能存在相关性,两者联合对VIC的诊断具有一定提示作用。
Objective To investigate the diagnostic value of deep medullary venous score combined with magnetic resonance imaging(MRI)burden score for vascular cognitive impairment(VIC)in elderly patients with cerebral small vessel disease(CSVD).Methods 188 elderly patients with CSVD were selected and divided into a VIC group of 123 cases and a non-VIC group of 65 cases based on whether they were complicated with VIC.According to the Montreal Cognitive Assessment(MoCA)score,the VIC group was divided into a non-severe VIC group of 91 cases and a severe VIC group of 32 cases.All patients under-went cranial MRI examination,and the deep medullary vein score and magnetic resonance burden score were calculated.Multi-variate logistic regression was used to analyze the influencing factors of VIC,and receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of deep medullary vein score and magnetic resonance burden score for VIC.Results There were significant differences in age,smoking history,past stroke history,hypertension,diabetes,hyperlipidemia,fasting blood glucose,total cholesterol,deep medullary vein score and magnetic resonance burden score between the VIC group and the non-VIC group(P<0.05).Hypertension,diabetes,hyperlipidemia,deep medullary vein score and magnetic resonance burden score were independent risk factors for VIC(P<0.05).The deep medullary vein score and magnetic resonance burden score were positively correlated with MMSE score and MoCA score(P<0.05).The deep medullary vein score and magnetic resonance bur-den score in the severe VIC group were higher than those in the non-severe VIC group(P<0.05).The sensitivity,specificity,and AUC of the combination of deep medullary vein score and magnetic resonance burden score in diagnosing VIC were 88.76%,51.32%,and 0.917,respectively.Conclusion The deep medullary vein score and the magnetic resonance burden score have correlation with cognitive function of the elderly CSVD patients,and the combination of these two scores has a suggestive role in the diagnosis of VIC.
作者
吴锦
谭覃
刘芬
邓士杰
WU Jin;TAN Qin;LIU Fen;DENG ShiJie(Department of Radiological Diagnosis,The 921st Hospital of the Joint Logistics Support Force of the People's Liberation Army ofChina,Changsha 410003,China;Department of Radiology,Xiangtan Central Hospital,Xiangtan 411100,China)
出处
《医学影像学杂志》
2024年第10期9-12,共4页
Journal of Medical Imaging
基金
中国人民解放军联勤保障部队第921医院一般新技术项目(编号:21Y1015001)。
关键词
脑小血管病
血管性认知障碍
深髓静脉评分
MRI负担评分
磁共振成像
Cerebral small vessel disease
Vascular cognitive impairment
Deep medullary vein score
Magnetic resonance burden score
Magnetic resonance imaging
