CAJ | 학술논문

目的：分析阿尔茨海默病（AD）和血管性痴呆（VD）的磁共振成像（MRI）表现，探讨MRI在鉴别诊断痴呆中作用。方法选取2011~2013年住院治疗的痴呆患者81例作为研究对象，其中AD 41例，VD 40例，对比分析两组患者MRI检查发现海马萎缩、脑萎缩、脑室改变、脑梗死、脑出血、脱髓鞘改变及无异常的发生比例。结果 AD组患者海马体积显著小于VD组，脑萎缩以颞、顶叶明显；VD可分为多发性脑梗死痴呆（MID）和皮层下动脉硬化性脑病（BD），分别表现为双侧半卵圆中心、双侧基底节及脑室旁白质对称或不对称的片状脑白质病变，脑萎缩呈全脑萎缩或局限性脑萎缩。结论根据AD和VD不同的颅脑MRI影像学特点，结合临床病理资料有助于对2种痴呆的鉴别诊断。
목적：분석아이자해묵병（AD）화혈관성치태（VD）적자공진성상（MRI）표현，탐토MRI재감별진단치태중작용。방법선취2011~2013년주원치료적치태환자81례작위연구대상，기중AD 41례，VD 40례，대비분석량조환자MRI검사발현해마위축、뇌위축、뇌실개변、뇌경사、뇌출혈、탈수초개변급무이상적발생비례。결과 AD조환자해마체적현저소우VD조，뇌위축이섭、정협명현；VD가분위다발성뇌경사치태（MID）화피층하동맥경화성뇌병（BD），분별표현위쌍측반란원중심、쌍측기저절급뇌실방백질대칭혹불대칭적편상뇌백질병변，뇌위축정전뇌위축혹국한성뇌위축。결론근거AD화VD불동적로뇌MRI영상학특점，결합림상병리자료유조우대2충치태적감별진단。
Objective To analyze the magnetic resonance imaging (MRI) expressions of Alzheimer′s disease (AD) and vascular dementia(VD),and explore the role of MRI in differential diagnosis of dementia. Methods A total of 81 patients with dementia,who were treated in the hospital in 2011-2013,were selected as research objects,including 41 cases of AD(AD group) and 40 cases of VD(VD group). To compare and analyze the proportion of hippocampal atrophy,encephalatrophy,ventricular changes, cerebral infarction,cerebral hemorrhage,brain myelin changes and normal by MRI performance in AD group and VD group. Re-sults The results showed that the patients′hippocampal volume in AD group was smaller than that in VD group ,and cerebral at-rophy in temporal and parietal was more obvious in AD group as well;VD could be divided into multi-infarct dementia(MID) and subcortical arteriosclerotic encephalopathy(Binswanger′s dementia,BD),the former showed bilateral centrum semiovale and symmetric or asymmetric patchy cerebral white matter degeneration in bilateral basal ganglia and paraventricle white matter , while the latter showed whole or focal brain atrophy. Conclusion According to the imaging characteristic of MRI in difference areas of brain between AD and VD,combination with clinical manifestations is beneficial to the differential diagnosis of AD and VD.