脑白质疏松症患者早期认知功能损害的特点及弥散张量成像研究

发布时间：2018-02-09 15:44

本文关键词： 脑白质疏松弥散张量成像认知功能感兴趣区各向异性系数　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析脑白质疏松症(LA)患者早期认知功能损害的临床特点和各感兴趣区磁共振弥散张量成像的FA值变化,并探讨LA患者白质变化与认知功能的相关性。方法:选择2015年8月至2016年10月在山西省人民医院收治的慢性缺血性LA患者38例和20例健康患者行常规MRI及DTI检查,采用神经心理学量表评价不同认知域损害特点,测量脑内不同感兴趣区的部分各向异性分数(FA值),并作相关性分析。结果:1.与对照组相比,LA患者早期认知功能损害特点,表现为总体认知功能减退,执行功能、记忆力、视空间结构技能、信息处理能力显著下降(P0.05),注意力无明显下降(P0.05)。2.LA患者在双侧侧脑室前角、左额上回、左额下回、双侧额叶眶回、右侧颞叶深部白质、右侧扣带回、胼胝体膝部FA值较正常对照组的FA值显著下降,差异有统计学意义(P0.05)。3.LA分级越严重,FA值越低,呈负相关(P0.05)。4.记忆力与左侧侧脑室前角、双侧额叶眶回、右颞叶深部白质、右扣带回、胼胝体膝部脑区呈正相关,与左额下回呈负相关(P0.05);信息处理能力与右侧侧脑室前角呈正相关,与右颞叶深部白质区呈负相关(P0.05);执行功能与左额叶眶回、右颞叶深部白质、右扣带回、胼胝体膝部等区FA值呈负相关(P0.05),视空间能力与左侧额叶眶回、右侧颞叶深部白质、胼胝体膝部呈正相关(P0.05)。结论:LA患者出现早期认知功能损害时,部分脑区FA值会发生变化,且与认知功能损害程度呈负相关。弥散张量成像有助于诊断脑白质疏松症患者早期认知功能损害。
[Abstract]:Objective: to analyze the clinical features of early cognitive impairment in patients with leukoaraiosis and the changes of FA values of diffusive Zhang Liang imaging in different areas of interest. Methods: from August 2015 to October 2016, 38 patients with chronic ischemic LA and 20 healthy controls were examined by routine MRI and DTI. The neuropsychological scale was used to evaluate the characteristics of cognitive impairment in different cognitive domains, and the partial anisotropic fraction (FA) of different regions of interest in the brain was measured, and the correlation analysis was made. Results: 1. Compared with the control group, the early cognitive impairment characteristics of LA patients were analyzed. The results showed that the overall cognitive function, executive function, memory, visual spatial structure skills, information processing ability were significantly decreased (P 0.05), and attention was not significantly decreased in patients with LA in bilateral anterior ventricle horn, left superior frontal gyrus, left inferior frontal gyrus, bilateral frontal orbital gyrus, bilateral frontal lobe orbital gyrus, bilateral frontal lobe orbital gyrus, left superior frontal gyrus, left superior frontal gyrus, bilateral frontal lobe orbital gyrus. The FA value of the deep white matter of the right temporal lobe, the right cingulate gyrus and the genu of corpus callosum was significantly lower than that of the normal control group, and the difference was statistically significant (P 0.05). 3. The more serious the grade of LA was, the lower the FA value was, and the negative correlation was found between the memory and the anterior horn of the left lateral ventricle. Bilateral frontal lobe orbital gyrus, deep white matter of right temporal lobe, right cingulate gyrus, genu of corpus callosum were positively correlated, and negatively correlated with left inferior frontal gyrus (P0.05). There was a negative correlation between the executive function and the FA values of left frontal lobe orbital gyrus, right temporal lobe deep white matter, right cingulate gyrus and genu of corpus callosum. The visual spatial ability was negatively correlated with the left frontal orbital gyrus and the deep white matter of right temporal lobe. The genu of corpus callosum had a positive correlation with P0.05.Conclusion the FA value of some brain regions will change in the early stage of cognitive impairment in patients with% LA. Diffusion Zhang Liang imaging was helpful in the diagnosis of early cognitive impairment in patients with leukoaraiosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R743

【参考文献】