皮质下缺血性血管病患者的扩散张量成像分析和认知功能相关研究

发布时间：2018-02-11 16:53

本文关键词： 皮质下缺血性血管病扩散张量成像基于图谱的分析认知　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的运用磁共振成像（magnetic resonance imaging，MRI）基于白质图谱的扩散张量成像（diffusion tensor imaging，，DTI）技术研究皮质下缺血性血管病（subcortical ischemic vascular disease，SIVD）患者白质超微结构改变，并分析DTI参数与认知功能的关系。方法连续入选22例非痴呆型血管性认知障碍（vascular cognitive impairment nodementia, VCIND）和28例认知功能正常（normal cognition, NC）的皮质下缺血性血管病患者，进行神经心理学和DTI检查。采用基于白质图谱的分析方法（atlas-based analysis, ABA），计算每个患者所有幕上白质纤维的各向异性指数（fractional anisotrophy，FA）、平均扩散率（mean diffusivity，MD），并对VCIND及NC两组患者进行组间差异性分析。此外，对SIVD患者DTI参数与蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）得分进行相关性分析。结果与NC组比较，VCIND组患者在所有幕上白质纤维的FA值减低、MD值增高，包括投射纤维（双侧内囊前、后肢及晶状体后部，双侧放射冠前部、上部、后部及丘脑后辐射），联络纤维（双侧矢状层、外囊、扣带、穹窿终纹、上纵束、上额枕束和钩束）以及连合纤维（胼胝体膝部、体部、压部及双侧毯部）（P均0.05）。另外，我们还发现MoCA评分与上述白质纤维的DTI参数存在显著的相关性。结论SIVD患者存在广泛脑解剖网络的白质连接异常，包括投射、联络及联合纤维。此外，白质纤维损害的严重程度与SIVD患者的认知功能紊乱相关，提示DTI白质图谱分析可以为进一步了解VCIND提供有用信息。
[Abstract]:Objective using magnetic resonance imaging (magnetic resonance, imaging, MRI) of diffusion tensor imaging of white matter based on mapping (diffusion tensor imaging, DTI) of subcortical ischemic vascular disease (subcortical ischemic vascular disease, SIVD) changes in patients with white matter ultrastructure, and analyze the relationship between DTI and cognitive function parameters.
Methods a total of 22 consecutive patients with non dementia vascular cognitive impairment (vascular cognitive impairment nodementia, VCIND) and 28 cases of normal cognitive function (normal, cognition, NC) of the patients with subcortical ischemic vascular disease, neuropsychological and DTI examination. The analysis method based on mapping of white matter (atlas-based analysis, ABA), calculated for each all patients with supratentorial white matter anisotropy index (fractional anisotrophy, FA), mean diffusivity (mean diffusivity, MD), and the VCIND and NC two groups by analysis of the difference among groups. In addition, patients with SIVD DTI parameters and the Montreal cognitive assessment scale (Montreal Cognitive Assessment, MoCA). Correlation analysis was carried out.
Results compared with NC group, VCIND group of patients in all supratentorial white matter fiber FA value decreased, MD value increased, including projection fibers (bilateral anterior and hind limbs and the posterior lens, bilateral anterior corona radiata, posterior upper and posterior thalamic radiation), contact fiber (bilateral sagittal layer, external capsule, buckle with fornix of the stria terminalis, superior longitudinal fasciculus, superior fronto occipital fasciculus and the uncinate fasciculus) and commissural fibers (genu, splenium and body of the bilateral blanket Department) (P 0.05). In addition, we also found that there was a significant correlation between the DTI score and the MoCA parameters of white matter fiber.
Conclusion SIVD patients have abnormal white matter, extensive brain anatomical network connections including projection, contact and combined with fiber. In addition, the cognitive dysfunction severity of white matter fiber damage in patients with SIVD, suggesting that DTI white matter atlas analysis can provide information for further understanding of the VCIND.

【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R743

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