| 摘要: |
| ［摘要］ 目的 基于磁共振弥散张量成像（DTI）技术探讨弓状束走行区域内腔隙性脑梗死患者的弓状束微结构改变对轻度认知功能的影响。方法 选择2022年9月至2023年6月双鸭山市人民医院收治的弓状束走行区域内腔隙性脑梗死患者64例，根据蒙特利尔认知评估（MoCA）量表评分将其分为轻度认知障碍（MCI）组（MoCA量表评分≥16分且<26分，35例）和非MCI组（MoCA量表评分≥26分，29例）。于同期纳入年龄、性别、受教育年限与患者相匹配的20名健康体检者作为对照组。研究对象均行核磁头部平扫加DTI检查，比较MCI组和非MCI组不同病灶数同侧弓状束DTI弥散指标水平和MoCA量表评分情况。结果 MCI组病灶数N<2者，左侧弓状束各向异性分数（FA）水平和MoCA量表评分高于2≤N<4者及N≥4者，右侧弓状束MoCA量表评分高于2≤N<4者及N≥4者；病灶数2≤N<4者，左侧、右侧弓状束MoCA量表评分均高于N≥4者，差异有统计学意义（P<0.05）。非MCI组病灶数N<2者，左侧、右侧弓状束FA水平均高于N≥4者，MD水平均低于N≥4者，且左侧弓状束MoCA量表评分高于2≤N<4者及N≥4者，右侧弓状束MoCA量表评分高于N≥4者；病灶数2≤N<4者，左侧、右侧弓状束MD水平均低于N≥4，差异有统计学意义（P<0.05）。结论 腔隙性脑梗死患者弓状束微结构改变与MCI有关，腔隙性脑梗死病灶数量越多，FA水平越低，弓状束损伤越严重，MoCA量表评分越低。对弓状束走行区域内的腔隙性脑梗死患者行核磁头部平扫加DTI检查弓状束微结构改变并结合MoCA量表评分可以作为评估MCI及预防阿尔茨海默病（AD）的重要方法。 |
| 关键词: 弥散张量成像 腔隙性脑梗死 弓状束微结构 认知功能 |
| DOI：10.3969/j.issn.1674-3806.2024.01.15 |
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| The DTI study on the effect of the changes in microstructure of arcuate fasciculus on mild cognitive function |
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HAN Songlin1,2, ZHANG Jian1
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1.Medical Imaging Center, the First Affiliated Hospital of Jiamusi University, Heilongjiang 154007, China; 2.CT MRI Room, People′s Hospital of Shuangyashan City, Heilongjiang 155100, China
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| Abstract: |
| ［Abstract］ Objective To explore the effect of the changes in microstructure of arcuate fasciculus on mild cognitive function in patients with arcuate fasciculus lacunar cerebral infarction in the walking area based on magnetic resonance diffusion tensor imaging(DTI) technique. Methods A total of 64 patients with arcuate fasciculus lacunar cerebral infarction in the walking area who were admitted to People′s Hospital of Shuangyashan City between September 2022 and June 2023 were selected. According to the Montreal Cognitive Assessment(MoCA) scale scores, the patients were divided into the mild cognitive impairment(MCI) group(35 cases with MoCA scale scores ≥16 and <26) and the non-MCI group(29 cases with MoCA scale scores ≥26). During the same period, 20 healthy examinees who matched the age, gender, and education years of the patients were included as the control group. All the research subjects underwent head nuclear magnetic scan plus DTI examination, and the DTI dispersion indicator levels of ipsilateral arcuate fasciculus were compared among different lesions as well as the MoCA scale scores between the MCI group and the non-MCI group. Results In the MCI group, when the number of lesions was N<2, the FA level and MoCA scale scores of the left arcuate fasciculus were higher than those when 2≤N<4 and N≥4, while the MoCA scale scores of the right arcuate fasciculus were higher than those when 2≤N<4 and N≥4; when the number of lesions was 2≤N<4, the MoCA scale scores of the left and right arcuate fasciculus were higher than those when N≥4, and the differences were statistically significant(P<0.05). In the non-MCI group, when the number of lesions was N<2, the FA levels of the left and right arcuate fasciculus were higher than those when N≥4, while the MD levels were lower than those when N≥4, and the MoCA scale scores of the left arcuate fasciculus were higher than those when 2≤N<4 and N≥4, while the MoCA scale scores of the right arcuate fasciculus were higher than those when N≥4; when the number of lesions was 2≤N<4, the MD levels of the left and right arcuate fasciculus were lower than those when N≥4, and the differences were statistically significant(P<0.05). Conclusion The changes in microstructure of arcuate fasciculus in patients with lacunar cerebral infarction are associated with MCI. The more lesions in lacunar cerebral infarction, the lower the FA level, and the more severe arcuate fasciculus injury and the lower MoCA scale scores. For the patients with arcuate fasciculus lacunar cerebral infarction in the walking area, head nuclear magnetic scan plus DTI examination can be used as important methods to evaluate MCI and prevent Alzheimer′s disease(AD) by examining the changes in microstructure of arcuate fasciculus and combining them with MoCA scale score. |
| Key words: Diffusion tensor imaging(DTI) Lacunar cerebral infarction Microstructure of arcuate fasciculus Cognitive function |
