裘雅各,吴小伟,汪耀,孙雅文,丁伟娜,韩旭,周滟.多模态MRI评价皮层下血管性认知功能障碍白质高信号半暗带[J].中国医学影像技术,2020,36(1):32~36
多模态MRI评价皮层下血管性认知功能障碍白质高信号半暗带
Multimodal MRI in evaluating white matter hyperintensity penumbras in patients with subcortical vascular cognitive impairment
投稿时间:2019-03-03  修订日期:2019-12-27
DOI:10.13929/j.issn.1003-3289.2020.01.009
中文关键词:  脑功能障碍  半暗带  磁共振成像
英文关键词:cognitive dysfunction  penumbra  magnetic resonance imaging
基金项目:上海市科委西医引导项目(17411964300)、上海交通大学高峰高原"双百人"计划(20172013)、国家自然科学基金(81901693)、上海交通大学医工交叉项目(NoYG2017QN47)、上海交通大学医学院附属仁济医院临床科研创新培育基金计划(PYIV-17-003)、仁济医院科研种子基金(RJZZ18-003)。
作者单位E-mail
裘雅各 上海交通大学医学院附属仁济医院放射科, 上海 200127  
吴小伟 上海交通大学医学院附属仁济医院放射科, 上海 200127  
汪耀 上海交通大学医学院附属仁济医院放射科, 上海 200127  
孙雅文 上海交通大学医学院附属仁济医院放射科, 上海 200127  
丁伟娜 上海交通大学医学院附属仁济医院放射科, 上海 200127  
韩旭 上海交通大学医学院附属仁济医院放射科, 上海 200127  
周滟 上海交通大学医学院附属仁济医院放射科, 上海 200127 clare1475@hotmail.com 
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中文摘要:
      目的 探讨不同MR成像技术评价皮层下血管性认知功能障碍(SVCI)患者脑白质高信号(WMH)半暗带(WMH-P)的价值。方法 对29例SVCI患者行弥散加权成像(DTI)、三维动脉自旋标记(3D-ASL)和酰胺质子化学交换饱和转移(CEST APT)扫描及神经心理学评估。将WMH周围1 cm范围为定义WMH-P,分别测量WMH、WMH-P及WMH-P以外正常表观白质(NAWM)的各项成像参数值,并与认知评分进行相关性分析。结果 FA和MD值在WMH、WMH-P及WMH-P以外NAWM之间差异均有统计学意义(P均<0.05),脑血流量(CBF)在WMH-P与WMH-P以外NAWM以及WMH与WMH-P以外NAWM之间均有统计学意义(P均<0.05)。WMH-P和WMH-P以外NAWM的FA值与MoCA评分呈显著正相关(P均<0.05)。结论 DTI技术与3D-ASL能反映SVCI患者脑白质病变范围及进展趋势;WMH-P的FA值能较好地评价SVCI患者认知功能水平。
英文摘要:
      Objective To explore the value of different MR techniques in evaluating white matter hyperintensity (WMH) penumbra (WMH-P) in patients with subcortical vascular cognitive impairment (SVCI). Methods A total of 29 SVCI patients underwent diffusion weight imaging (DTI), 3D-arterial spin labeling (3D-ASL) and chemical exchange saturation transfer amide proton transfer (CEST APT) scans as well as neuropsychological evaluation. WMH-P was defined in the range of 1 cm around WMH. Imaging parameters of WMH, WMH-P and normal appearing white matter (NAWM) outside WMH-P were measured and analyzed with cognitive scores. Results There were significant differences of FA and mean diffusivity MD values among WMH, WMH-P and NAWM outside WMH-P (all P<0.05), also of cerebral blood flow (CBF) between WMH-P and NAWM outside WMH-P, as well as between WMH and NAWM outside WMH-P (all P<0.05). FA value in WMH-P and NAWM outside WMH-P was positively correlated with Montreal cognitive assessment (MoCA) scores (all P<0.05). Conclusion 3D-ASL and DTI techniques can be used to reflect the extent and progression of white matter lesions in patients with SVCI. FA value of WMH-P can well evaluate the cognitive function of SVCI patients.
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