磁共振波谱成像对检测非痴呆型血管性认知障碍的探讨

doi:10.6040/j.issn.1671-7554.0.2018.1341

摘要/Abstract

摘要： 目的通过磁共振波谱成像技术(MRS)对非痴呆型血管认知功能障碍(VCIND)患者脑内代谢参数的测量,探讨脑内关键部位代谢改变与VCIND相关性。方法利用3.0T MRS检测 VCIND患者(n=38例,VCIND组)与正常查体者(n=44例,正常对照组)在双侧额叶、颞叶、丘脑、海马、基底节及扣带回区的N-乙酰天冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值及NAA/Cr、Cho/Cr比值,比较两组优势半球的代谢改变并行统计学分析。结果与正常对照组相比,VCIND组优势半球颞叶、海马、丘脑及扣带回区NAA值和额叶、海马、丘脑、扣带回NAA/Cr比值均降低,差异有统计学意义(P<0.05);两组优势半球不同部位Cho及Cho /Cr 值差异无统计学意义(P>0.05); VCIND组内优势侧与非优势侧各部位间代谢参数值差异均无统计学意义(P>0.05)。结论 NAA 及NAA/Cr 是检测VCIND的敏感指标,VCIND患者在脑内广泛代谢异常,但优势半球额叶、颞叶、海马、丘脑、扣带回代谢改变与VCIND密切相关。

关键词: 血管性认知功能障碍, 非痴呆型血管性认知障碍, 磁共振波谱成像, 磁共振成像, 代谢异常

Abstract: Objective To explore the relevance between metabolic changes in the critical parts of brain and vascular cognitive impairment no dementia(VCIND)by analyzing the metabolite ratios in VCIND patients using magnetic resonance spectroscopy(MRS). Methods A total of 38 VCIND patients(VCIND group)and 44 healthy controls(control group)were involved. The N-acetyl aspartate(NAA), choline(Cho), creatine(Cr), NAA/Cr and Cho/Cr in the frontal lobe, temporal lobe, thalamus, hippocampus, basal ganglia and cingulate gyrus in the two groups were measured with 3.0T MRS. The above parameters in dominant hemisphere of the two groups were compared and statistically analyred. Results Compared with the control group, the VCIND group had significantly reduced NAA in the temporal lobe, hippocampus, thalamus, and cingulate gyrus, and decreased NAA/Cr ratio in the frontal lobe, hippocampus, thalamus and cingulate gyrus (P<0.05). There were no statistical differences in Cho and Cho/Cr in different parts in the dominant hemisphere between two groups(P>0.05). There were no significant differences in all of the parameters between the dominant and non-dominant hemisphere in the VCIND group. Conclusion NAA and NAA/Cr are sensitive indicators to detect VCIND. VCIND patients have extensive cerebral metabolic disorder, but in the dominant hemisphere, the metabolic changes were associated with VCIND in the frontal lobe, temporal lobe, hippocampus, thalamus, and cingulate gyrus. 山东大学学报 (医学版)57卷4期 -张晓倩,等.磁共振波谱成像对检测非痴呆型血管性认知障碍的探讨 \=-

Key words: Vascular cognitive impairment, Vascular cognitive impairment no dementia, Magnetic resonance spectroscopy, Magnetic resonance imaging, Metabolic disorder

中图分类号:

R749

张晓倩,孟祥水,任庆国,南晓敏,安盼盼,帅欣艳,夏晓娜,王璇. 磁共振波谱成像对检测非痴呆型血管性认知障碍的探讨[J]. 山东大学学报 (医学版), 2019, 57(4): 42-46.

ZHANG Xiaoqian, MENG Xiangshui, REN Qingguo, NAN Xiaomin, AN Panpan, SHUAI Xinyan, XIA Xiaona, WANG Xuan. Magnetic resonance spectroscopy in patients with vascular cognitive impairment no dementia[J]. Journal of Shandong University (Health Sciences), 2019, 57(4): 42-46.

参考文献

[1] Smith EE. Clinical presentations and epidemiology of vascular dementia[J]. Clin Sci(Lond), 2017, 131(11): 1059-1068.
[2] 赵维纳, 韩璎. 血管性认知障碍的影像学研究[J]. 中国卒中杂志, 2018, 13(7): 647-650.
[3] 张晓倩, 孟祥水. 多模态功能MRI对血管性认知障碍的研究进展[J]. 国际医学放射学杂志, 2019, 42(1): 59-61. ZHANG Xiaoqian, MENG Xiangshui. Research progress of multi-modality functional magnetic resonance imaging on vascular cognitive impairment[J]. International Journal of Medical Radiology, 2019, 42(1): 59-61.
[4] Hachinski V, Iadecola C, Petersenrc, et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards[J]. Stroke, 2006, 37(9): 2220-2241.
[5] Zhang C, Zhe Y, Lan T, et al. Study on epidemiology of cognitive dysfunction after stroke in the population over the age of 45 in Inner Mongolia[J]. Int J Neurosci, 2018, 128(7): 654-662.
[6] 孙宇, 韩璎, 戴建平, 等. 血管性认知障碍诊断标准的演变与解读[J]. 中国卒中杂志, 2017, 12(1): 13-17.
[7] Sharma S. Translational multimodality neuroimaging[J]. Curr Drug Targets, 2017, 18(9): 1039-1050.
[8] Joe E, Medina LD, Ringman JM, et al. ¹H MRS spectroscopy in preclinical autosomal dominant alzheimer disease[J]. Brain Imaging Behav, 2018, 1: 1-8. doi:10.1007/s11682-018-9913-1.
[9] Boban J, Kozic D, Turkulov V, et al. HIV-associated neurodegeneration and neuroimmunity: multivoxel MR spectroscopy study in drug-naive and treated patients[J]. Eur Radiol, 2017, 27(10): 4218-4236.
[10] Veenith TV, Mada M, Carter E, et al. Comparison of inter subject variability and reproducibility of whole brain proton spectroscopy[J]. PLoS One, 2014, 9(12): e115304. doi:10.1371/journal.pone.0115304.
[11] 黄明明, 曹笑婉, 沈桂权, 等. 应用3.0 T 1H-MRS技术纵向评估血管性认知障碍大鼠脑内代谢物改变[J]. 磁共振成像, 2017, 8(9): 691-696. HUANG Mingming, CAO Xiaowan, SHEN Guiquan, et al. A longitudinal study of changes of brain metabolites in vascular cognitive impairment rats using 3.0 T 1H-MRS[J]. Chinese Journal of Magnetic Resonance Imaging, 2017, 8(9): 691-696.
[12] 刘娟, 李文, 王润榕, 等. 无痴呆型血管性认知障碍患者多体素质子磁共振波谱的诊断价值[J]. 中华神经科杂志, 2010, 43(9): 607-611. LIU Juan, LI Wen, WANG Runrong, et al. A study of multi-voxel 1H-magnetic resonance spectroscopy in patients with vascular cognitive impairment no dementia[J]. Chinese Journal of Neurology, 2010, 43(9): 607-611.
[13] Sullivan MO, Morris RG, Markus HS. Brief cognitive assessment for patients with cerebral small vessel disease[J]. J Neurol Neurosurg Psychiatry, 2005, 76(8): 1140-1145.
[14] Gong L, Hou Z, Wang Z, et al. Disrupted topology of hippocampal connectivity is associated with short-term antidepressant response in major depressive disorder[J]. J Affect Disord, 2018, 225: 539-544. doi: 10.1016/j.jad.2017.08.086.
[15] Ho TC, Sacchet MD, Connolly CG, et al. Inflexible functional connectivity of the dorsal anterior cingulate cortex in adolescent major depressive disorder[J]. Neuropsychopharmacology, 2017, 42(12): 2434-2445.
[16] 陆强彬, 张慧萍, 朱祖福, 等. 血管性认知功能障碍磁共振波谱成像研究[J]. 蚌埠医学院学报, 2016, 41(12): 1673-1675. LU Qiangbin, ZHANG Huiping, ZHU Zufu, et al. Study of the magnetic resonance spectroscopy in patients with vascular cognitive impairment[J]. Journal of Bengbu Medical College, 2016, 41(12): 1673-1675.
[17] Liu YY, Yang ZX, Shen ZW, et al. Magnetic resonance spectroscopy study of amnestic mild cognitive impairment and vascular cognitive impairment with no dementia[J]. Am J Alzheimers Dis Other Demen, 2014, 29(5): 474-481.
[18] Chen SQ, Cai Q, Shen YY, et al. Hydrogen proton magnetic resonance spectroscopy in multidomain amnestic mild cognitive impairment and vascular cognitive impairment without dementia[J]. Am J Alzheimers Dis Other Demen, 2016, 31(5): 422-429.
[19] 郑璐. 不同亚型aMCI的认知行为及脑影像学对比研究[D]. 北京: 北京师范大学, 2011.
[20] Hamoda HM, Makhlouf AT, Fitzsimmons J, et al. Abnormalities in thalamo-cortical connections in patients with first-episode schizophrenia: A two-tensor tractography study[J]. Brain Imaging Behav, 2018: 17. doi: 10.1007/s11682-018-9862-8.
[21] Yan T, Yu JR, Zhang YP, et al. Analysis on correlation of white matter lesion and lacunar infarction with vascular cognitive impairment[J]. Int J Clin Exp Med, 2015, 8(8): 14119-14122.
[22] Thaler A, Kliper E, Maidan I, et al. Cerebral imaging markers of GBA and LRRK2 related parkinsons disease and their first-degree unaffected relatives[J]. Brain Topogr, 2018, 31(6): 1029-1036.
[23] Moreno-Alcázar A, Gonzalvo B, Canales-Rodríguez EJ, et al. Larger gray matter volume in the basal ganglia of heavy cannabis users detected by voxel-based morphometry and subcortical volumetric analysis[J]. Front Psychiatry, 2018, 9: 175. doi: 10.3389/fpsyt.2018. 00175.
[24] 于洋, 尹昌浩. 血管性认知障碍的多模态影像学研究进展[J]. 中国全科医学, 2016, 19(29): 3629-3633. YU Yang, YIN Changhao. Research progress of multi-modality imaging of vascular cognitive disorders [J]. Chinese General Practice, 2016, 19(29): 3629-3633.
[25] Bella R, Cantone M, Lanza G, et al. Cholinergic circuitry functioning in patients with vascular cognitive impairment-no dementia[J]. Brain Stimul, 2016, 9(2): 225-233.
[26] Zhu X, Cao L, Hu X, et al. Brain metabolism assessed via proton magnetic resonance spectroscopy in patients with amnestic or vascular mild cognitive impairment[J]. Clin Neurol Neurosurg, 2015, 130: 80-85. doi: 10.1016/j.clineuro.2014.12.005.
[27] Liu Q, Zhu Z, Teipel SJ, et al. White matter damage in the cholinergic system contributes to cognitive impairment in subcortical vascular cognitive impairment, no dementia[J]. Front Aging Neurosci, 2017, 9(7): 47-56.
[28] 谭子虎, 兰汉超, 杨琼, 等. 非痴呆型血管性认知功能障碍的磁共振波谱分析特点[J]. 临床神经病学杂志, 2013, 26(5): 325-328. TAN Zihu, LAN Hanchao, YANG Qiong, et al. Magnetic resonance spectroscopy features of vascular cognitive impairment with no dementia[J]. Journal of Clinical Neurology, 2013, 26(5): 325-328.

相关文章 15

[1]	金晨曦,沈薇,李娜,孙建锋,杨驰,郭泾. ADDWoR关节镜下盘复位术盘-髁运动的定量分析[J]. 山东大学学报 (医学版), 2025, 63(7): 54-61.
[2]	刘晶晶,庞婧,赵晓丹,林昕,付敏,陈静静. 基于乳腺X线摄影及DCE-MRI机器学习模型预测乳腺癌新辅助治疗后病理完全缓解:双中心研究[J]. 山东大学学报 (医学版), 2025, 63(1): 60-72.
[3]	刘小文,曹永泉,侯明源,于德新. EOB-MRI多定量参数对肝胆期乏血供低信号结节进展风险的评估价值[J]. 山东大学学报 (医学版), 2024, 62(4): 31-39.
[4]	吴雪燕,高英静,刘思言,王少莲. 以手足及面部麻木为首发表现的青少年孤立肾漏诊1例并文献复习[J]. 山东大学学报 (医学版), 2024, 62(3): 121-124.
[5]	赵智博,满振涛,李伟. 胆固醇代谢在骨关节炎疾病中的作用及研究进展[J]. 山东大学学报 (医学版), 2024, 62(2): 1-9.
[6]	吴思雨,沈业隆,王锡明. 影像组学预测原发性中枢神经系统淋巴瘤的Ki-67标记指数[J]. 山东大学学报 (医学版), 2024, 62(11): 67-72.
[7]	靳新娟,左立平,邓展昊,李安宁,于德新. MRI影像组学对135例肝癌耐药蛋白PFKFB3的预测价值[J]. 山东大学学报 (医学版), 2023, 61(6): 79-86.
[8]	王磊,张帅,刘钢,由胜男,王植,朱珊,陈超,马信龙,杨强. MRI诊断140例腰椎智能网络自动检测分型MCs方法的比较[J]. 山东大学学报 (医学版), 2023, 61(3): 71-79.
[9]	杨咏青,赵鹏,汪玉,马文静,田迷迷,程亚旎,祖璐,林祥涛. 细胞外容积分数对62例不同病理类型肺癌的诊断价值[J]. 山东大学学报 (医学版), 2023, 61(2): 88-94.
[10]	靳新娟,蔡大幸,范金蕾,邓展昊,李楠,于德新,李安宁. 显微镜高分辨率MRI鉴别皮肤良、恶性局灶隆起性结节[J]. 山东大学学报 (医学版), 2023, 61(12): 51-61.
[11]	赵恩举,赵硕,郭云亮,王锡明. 282例颈动脉钙化与脑小血管病MRI总负荷评分的关联性[J]. 山东大学学报 (医学版), 2023, 61(1): 38-44.
[12]	陶国伟,王芳,董向毅,徐亚瑄,赵琳丽,胡蓓蓓. 子宫腺肌病的超声与MRI诊断及进展[J]. 山东大学学报 (医学版), 2022, 60(7): 56-65.
[13]	冯宝民,王舟,徐晗,李佳存,于乔文,修建军. 抗髓鞘少突胶质细胞糖蛋白IgG抗体相关疾病临床及影像特征[J]. 山东大学学报 (医学版), 2022, 60(3): 45-50.
[14]	左立平,蒋丰洋,周斌彬,范金蕾,梁永锋,邓展昊,于德新. 术前MRI在预测169例肝细胞肝癌微血管侵犯及早期复发的价值[J]. 山东大学学报 (医学版), 2022, 60(3): 89-95.
[15]	刘学业,李齐明,唐弘毅,徐秋平,陈文倩,郭泾. 年轻成人颞下颌关节髁突体积、表面积与关节盘矢向位置的关系[J]. 山东大学学报 (医学版), 2021, 59(6): 117-121.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed