CAJ | 학술논문

目的：探讨弥散张量成像技术（diffusion tensor imaging，DTI）对遗忘型轻度认知功能障碍（aMCI）向老年性痴呆（ AD）转化的预测作用。方法：41例 aMCI 患者（aMCI 组）常规予核磁共振（MRI）和 DTI 扫描，测定感兴趣区的各向异性分数（ fractional anisotropy，FA）和表观扩散系数（apparent diffusion coefficient，ADC），以20名老年健康志愿者作为对照（正常对照组）并随访1~3年。结果：与正常对照组比较，aMCI 组41例患者中有22例扣带束 FA 基线值偏低（P ﹤0.05），随访1~3年后，其中有19例转化为 AD；另外19例扣带束 FA 值正常的 aMCI 患者只有2例转化为 AD。与非转化 AD 者比较，AD 转化者前额叶、颞叶、海马、下额枕束、胼胝体膝部和扣带束等部位 FA 值降低（P 均﹤0.01），颞叶、海马等部位 ADC 值升高（P 均﹤0.05）。结论：DTI 技术具有预测 aMCI 向 AD 转化的作用，aMCI患者扣带束 FA 值低可能是 aMCI 向 AD 转化的敏感指标。
목적：탐토미산장량성상기술（diffusion tensor imaging，DTI）대유망형경도인지공능장애（aMCI）향노년성치태（ AD）전화적예측작용。방법：41례 aMCI 환자（aMCI 조）상규여핵자공진（MRI）화 DTI 소묘，측정감흥취구적각향이성분수（ fractional anisotropy，FA）화표관확산계수（apparent diffusion coefficient，ADC），이20명노년건강지원자작위대조（정상대조조）병수방1~3년。결과：여정상대조조비교，aMCI 조41례환자중유22례구대속 FA 기선치편저（P ﹤0.05），수방1~3년후，기중유19례전화위 AD；령외19례구대속 FA 치정상적 aMCI 환자지유2례전화위 AD。여비전화 AD 자비교，AD 전화자전액협、섭협、해마、하액침속、변지체슬부화구대속등부위 FA 치강저（P 균﹤0.01），섭협、해마등부위 ADC 치승고（P 균﹤0.05）。결론：DTI 기술구유예측 aMCI 향 AD 전화적작용，aMCI환자구대속 FA 치저가능시 aMCI 향 AD 전화적민감지표。
Objective:To evaluate the predictive role of diffusion tensor imaging(DTI)in patients with amnesic type mild cognitive impairment(aMCI)converting to Alzheimer′s disease(AD). Method:Forty-one aMCI patients(aMCI group)and 20 healthy volunteers(normal control group)as controls were recruited in this study. After routine magnetic resonance and DTI scans were completed,fractional anisotropy(FA)and apparent diffusion coefficient(ADC)values were measured and compared on different regions of interest(ROI). All of the participants were follow-up for 1-3 years. Results:Compared to controls,22 subjects in the aMCI group had low-er FA values in the cingulate fasciculus at baseline(P ﹤ 0. 05). 19 cases of them converted to AD the follow-up. Only 2 of the other 19 aMCI patients with normal FA values converted to AD. Compared to non-AD converters, AD converters showed lower FA values in the anterior frontal lobe,temporal lobe,hippocampus,inferior fronto-occipital fascicles,corpus callosum genu and cingulate fasciculus(all P ﹤ 0. 01),and higher apparent diffusion coefficient values in the temporal lobe and hippocampus(all P ﹤0. 05). Conclusion:DTI scans provide a pre-dictive effect on the clinical conversion from aMCI to AD. For aMCI patients,lower FA value in the cingulate fasciculus may be a sensitive indicator of aMCI conversion to AD.