基于结构磁共振成像评估皮质下缺血性脑血管病伴认知障碍患者灰质萎缩的影像学研究 [中文引用][英文引用]

【摘要】：目的：基于结构磁共振成像（sMRI）中的体素形态测量法（VBM）全自动分割脑组织，探索皮质下缺血性脑血管病（SIVD）伴认知障碍患者脑灰质体积变化与认知损害领域的相关性。方法：收集2020年9月至2022年9月牡丹江医学院附属红旗医院神经内科患者80例，根据神经心理学评估认知水平下降程度将受试者分为皮质下缺血性脑血管病痴呆组(SIVD-AD)23例，轻度认知障碍组(SIVD-MCI)33例和无认知障碍组(SIVD-NCI)24例。应用3.0T MRI采集3D-T1TFE矢状位结构像，在MATLAB平台SPM12软件包中的VBM-CAT12工具箱将脑组织进行全自动分割，最终在DPABI软件中进行感兴趣区勾画，所有图像均应用Viewer软件包中的AAL模板进行萎缩部位校准。结果：与SIVD-NCI组相比，SIVD-MCI组主要在右侧额上回、额中回及颞中回中存在灰质萎缩改变；SIVD-VAD组主要在双侧梭状回、双侧扣带回、双侧嗅皮层、左侧额上回、左侧额中回、左侧海马旁回、左侧直回、左侧岛叶、右侧尾状核等存在萎缩改变。结论：sMRI具有非侵入无辐射的特点，可作为一般人群中MCI及AD的有效筛查选择，在改善临床实践中具有重要价值。

 [Abstract]  Objective To explore the correlation between changes in the volume of gray matter and cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) with cognitive impairment based on the voxel morphology measurement (VBM) method in structural magnetic resonance imaging (sMRI) to fully automatic segmentation of brain tissue. Methods  From September 2020 to September 2022, 80 patients from the Department of Neurology of Hongqi Hospital Affiliated to Mudanjiang Medical College were collected, and the subjects were divided into dementia group (SIVD-AD, n=23), mild cognitive impairment group (SIVD-MCI, n=33) and non-cognitive impairment group (SIVD-NCI, n=24) according to the neuropsychological assessment of the degree of cognitive decline. The 3D-T1TFE sagittal structure image was collected by 3.0T MRI, and the brain tissue was automatically segmented by VBM-CAT12 toolbox in SPM12 software package of MATLAB platform, and the regions of interest were delineated in the DPABI software. All images were calibrated for atrophy using the AAL template in the Viewer package. Results  Compared with the SIVD-NCI group, the SIVD-MCI group mainly showed gray matter atrophy changes in the right frontal upper gyrus, midfrontal gyrus and temporal middle gyrus. The SIVD-VAD group mainly showed atrophic changes in the bilateral fusiform gyrus, bilateral cingulate gyrus, bilateral olfactory cortex, left supra frontal gyrus, left midfrontal gyrus, left parahippocampal gyrus, left straight gyrus, left insular lobe and right caudate nucleus. Conclusion  sMRI has the characteristics of non-invasive and radiation-free, which can be used as an effective screening choice for MCI and AD in the general population, and has important value in improving clinical practice.