摘要
目的探讨磁共振波谱(1H-MRS)在遗忘型轻度认知障碍(aMCI)与非遗忘型轻度认知障碍(na MCI)鉴别诊断中的应用价值。方法对明确诊断的25例aMCI患者(a MCI组)、22例na MCI患者(naMCI组)及20例认知功能正常老年人(NC组),行多体素1H-MRS检查,以左侧海马、扣带后回及额叶为兴趣区,检测N-乙酰天门冬氨酸(NAA)、谷氨酸(Glu)、肌醇(mI)及肌酸(Cr)的峰下面积。使用SPSS 17.0软件包对所测定的数据进行分析,3组间NAA/Cr、mI/Cr及Glu/Cr值的比较使用单因素方差分析,组间两两比较用最小差值显著法(LSD)进行统计分析。结果 aMCI组和naMCI组在左侧海马的NAA/Cr值(分别为1.09±0.11、1.07±0.08)均低于NC组(1.20±0.21),差异有统计学意义(F=10.23,P<0.05);aMCI组和naMCI组在左侧扣带后回的NAA/Cr值(分别为1.02±0.09、1.07±0.10)也低于NC组(1.22±0.18),差异有统计学意义(F=8.73,P<0.05);aMCI组和na MCI组在海马与扣带后回的NAA/Cr值差异无统计学意义(F=1.54,P>0.05)。aMCI组扣带后回Glu/Cr值(0.35±0.04)低于naMCI组与NC组(0.43±0.02、0.42±0.05),差异有统计学意义(F=8.44,P<0.05);3组间的Glu/Cr值在海马和扣带后回的均差异无统计学意义(F=0.38,0.36;P>0.05)。aMCI组在海马的m I/Cr值(0.66±0.07)高于naMCI组和NC组(分别为0.39±0.04、0.41±0.04),差异有统计学意义(F=11.47,P<0.05);aMCI组在扣带后回的m I/Cr值(0.62±0.05)高于naMCI组和NC组(分别为0.42±0.03、0.44±0.04),差异有统计学意义(F=9.41,P<0.05);naMCI组在额叶区的m I/Cr值(0.58±0.04)高于aMCI组和NC组(分别为0.43±0.03、0.41±0.03),差异有统计学意义(F=7.83,P<0.05)。结论 aMCI及naMCI组患者脑内m I及Glu代谢存在区域性的差异,1H-MRS为临床鉴别a MCI及naMCI提供了有效的依据。
Objective To investigate the value of hydrogen proton magnetic resonance spectroscopy （IH-MRS） in the differential diagnosis of amnestic mild cognitive impairment （aMCI） and non-amnestic mild cognitive impairment （naMCI）.Methods Twenty-five cases of aMCI patients were enrolled ,twenty-two cases with naMCI and twenty subjects were elderly with normal cognitive function （NC）.They all received examination of 1H-MRS.The regions of interest were examined, including the left hippocampus, the posterior cingulate gyms, and the frontal lobes. The area under the peak was determined for N-acethyl aspartate （ NAA）, glutamate （Glu） ,inositol （mI） and creatine （Cr） .The ratios of NAA/Cr, Glu/Cr and mL/Cr were compared in different brain regions among the three groups with SPSS 17.0.Results Compared with the NC group, the ratio of NAA/Cr in the left hippocampus group was significantly lower than that in the aMCI and naMCI groups （ 1.09±0.11,1.07±0.08,1.20±0.21 ; t = 0.247,0.312 ; all P 〈0.05 ）, and the ratio of NAA/Cr in the left posterior cingulate gyrus group was also significantly reduced with those in the aMCI and naMCI groups （ 1.02±0,09,1.07±0.10,1.22±0.18 ; t = 0.442,0.381 ; all P 〈 0.05 ）.However, no significant difference in the ratio of NAA/Cr in any brain region were observed between aMCI and naMCI groups （ t = 0.021, 0.036; P〉0.05）.The Glu/Cr ratio in the posterior cingulate gyrus of the aMCI group decreased significantly compared with that in the naMCI and NC groups （0.35±0.04,0.43±0.02,0.42±0.05; t = 0.474,0.405;all P 〈 0.05） .No significant difference in the Glu/Cr ratio was observed in other brain regions among the three groups （ F = 0.382,0.363;all P 〉0.05）.The mI/Cr ratio in the bippocampus was significantly bigger in the aMCI group than that in the naMCI and NC groups （0.66±0.07,0.39±0.04,0.41±0.04; t =0.293,0.247 ;all P 〈0.05） , and the ml/Cr ratio in the posterior cingulate gyrus was also significantly higher in the aMCI group t
出处
《中华诊断学电子杂志》
2015年第3期5-9,共5页
Chinese Journal of Diagnostics(Electronic Edition)
基金
国家自然科学基金(81171297)
关键词
认知障碍
痴呆
磁共振波谱学
Cognition impairment
Dementia
Magnetic resonance spectroscopy
