CAJ | 학술논문

目的：探讨脑小血管病（SVD）患者脑部MR弥散张量成像（DTI）的改变及其与认知功能障碍的关系。方法给55例SVD患者进行神经心理学量表检查，评定认知功能状态，以及行常规MRI和DTI检查，观察感兴趣区的各向异性分数（FA）、表观弥散系数（ADC）。对DTI FA值与蒙特利尔认知评估（MoCA）量表评分的相关性用Pearson相关分析。结果本组SVD患者中认知功能正常（ NCI）的患者25例，非痴呆认知功能障碍（ VCIND）患者30例。与NCI组比较，VCIND组双侧半卵圆中心、丘脑、额叶及左侧尾状核的FA值显著降低（P＜0.05～0．001）；双侧豆状核、右侧尾状核FA值的差异无统计学意义；左侧尾状核ADC值显著增高（P＜0.05），其他部位ADC值的差异均无统计学意义。 Pearson相关分析示，双侧半卵圆中心、额叶及左侧尾状核的FA值与MoCA量表评分呈正相关（r＝0.279～0．375，P＜0.05～0．005）。结论有认知功能障碍的SVD患者额叶及脑白质DTI的FA值明显降低，并与其认知功能障碍程度有密切的关系。
목적：탐토뇌소혈관병（SVD）환자뇌부MR미산장량성상（DTI）적개변급기여인지공능장애적관계。방법급55례SVD환자진행신경심이학량표검사，평정인지공능상태，이급행상규MRI화DTI검사，관찰감흥취구적각향이성분수（FA）、표관미산계수（ADC）。대DTI FA치여몽특리이인지평고（MoCA）량표평분적상관성용Pearson상관분석。결과본조SVD환자중인지공능정상（ NCI）적환자25례，비치태인지공능장애（ VCIND）환자30례。여NCI조비교，VCIND조쌍측반란원중심、구뇌、액협급좌측미상핵적FA치현저강저（P＜0.05～0．001）；쌍측두상핵、우측미상핵FA치적차이무통계학의의；좌측미상핵ADC치현저증고（P＜0.05），기타부위ADC치적차이균무통계학의의。 Pearson상관분석시，쌍측반란원중심、액협급좌측미상핵적FA치여MoCA량표평분정정상관（r＝0.279～0．375，P＜0.05～0．005）。결론유인지공능장애적SVD환자액협급뇌백질DTI적FA치명현강저，병여기인지공능장애정도유밀절적관계。
Objective To explore the change of MR diffusion tensor imaging ( DTI ) and its correlation with cognitive impairment in patients with cerebral small vessel disease ( SVD) .Methods Neuropsychological scales were conducted in 55 SVD patients to evaluate their cognitive functional status .All the 55 cases underwent conventional MRI and DTI, the fractional anisotropy ( FA) and average diffusion coefficient ( ADC) values were measured in the regions of interest .Pearson correlation analysis was used to determine the correlation between the FA value of DTI and Montreal Cognitive Assessmen (MoCA) scale score.Results Of the enrolled patients,25 cases were with normal cognitive function(NCI) and 30 cases were with cognitive impairment without dementia (VCIND).Compared with the NCI group,The VCIND patients had lowered FA values in the bilateral centrum semiovale ,thalamus,frontal lobes and the left caudate nucleus(P<0.05-0.001);the FA values of bilateral lentiform nucleus and right caudate nucleus had no significant difference;The ADC value was significantly increased in the left caudate nucleus ( P<0.05 ) , the ADC values of other parts had no significant difference .Pearson correlation analysis showed that the FA values of bilateral centrum semiovale , frontal lobe and left caudate nucleus were positively correlated with MoCA scale scores (r=0.279-0.375,P<0.05-0.005).Conclusion The SVD patients with cognitive impairment have a significant decrease in their FA values of frontal lobe and white matter which are closely related to cognitive impairment .