CAJ | 학술논문

目的通过比较正常人、轻度认知障碍(MCI)和阿尔茨海默病(AD)患者海马、内嗅皮质体积,探讨MRI测量海马和内嗅皮质体积对诊断MCI及AD的临床意义.方法从住院及门诊体检者中筛选MCI者42例(MCI组),阿尔茨海默病(AD)者38例(AD组),认知功能正常(NC)者42例(NC组),进行一般情况检查和神经心理量表测评.应用MRI测量海马和内嗅皮质体积,并分析其与简易智力量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分的相关性.结果 MCI组海马和内嗅皮质体积分别为(6.29±1.13) cm3和(2.71 ±0.51) cm3;显著小于NC组的(7.01 ±0.92)cm3和(3.12±0.34) cm3(P均＜0.05),AD组海马和内嗅皮质体积分别为(5.10±1.07) cm3和(2.09±0.68)cm3,与NC组相比明显减小(P均＜0.01),和MCI组相比AD组海马、内嗅皮质体积明显缩小(P均＜0.01).海马体积与MMSE评分正相关(r =0.770,P＜0.01),内嗅皮质体积与MMSE正相关(r=0.811,P＜0.01),海马体积与MoCA评分正相关(r=0.810,P＜0.01),内嗅皮质体积与MoCA正相关(r=0.842,P＜0.01).结论内嗅皮质和海马体积萎缩与认知障碍和AD密切相关,MRI测量内嗅皮质和海马体积对MCI与AD的早期诊断具有一定的临床价值.
목적 통과비교정상인、경도인지장애(MCI)화아이자해묵병(AD)환자해마、내후피질체적,탐토MRI측량해마화내후피질체적대진단MCI급AD적림상의의.방법 종주원급문진체검자중사선MCI자42례(MCI조),아이자해묵병(AD)자38례(AD조),인지공능정상(NC)자42례(NC조),진행일반정황검사화신경심리량표측평.응용MRI측량해마화내후피질체적,병분석기여간역지역량표(MMSE)、몽특리이인지평고량표(MoCA)평분적상관성.결과 MCI조해마화내후피질체적분별위(6.29±1.13) cm3화(2.71 ±0.51) cm3;현저소우NC조적(7.01 ±0.92)cm3화(3.12±0.34) cm3(P균＜0.05),AD조해마화내후피질체적분별위(5.10±1.07) cm3화(2.09±0.68)cm3,여NC조상비명현감소(P균＜0.01),화MCI조상비AD조해마、내후피질체적명현축소(P균＜0.01).해마체적여MMSE평분정상관(r =0.770,P＜0.01),내후피질체적여MMSE정상관(r=0.811,P＜0.01),해마체적여MoCA평분정상관(r=0.810,P＜0.01),내후피질체적여MoCA정상관(r=0.842,P＜0.01).결론 내후피질화해마체적위축여인지장애화AD밀절상관,MRI측량내후피질화해마체적대MCI여AD적조기진단구유일정적림상개치.
Objective To investigate the imaging features of hippocampus and entorhinal cortex in the normal,mild cognitive impairment(MCI) and Alzheimer's disease (AD),and explore the value of diagnosing MCI and AD by using the method of MRI measuring the volume of hippocampus and entorhinal cortex.Method One hundred and twenty-two people including 42 cases of MCI,38 cases of AD,and 42 cases of noroal cognition(NC) were selected as our subjects from health examination persons both in hospital and outpatient service.All were performed general examination and neuropsychological scale evaluation.The volume of hippocampus and entorhinal cortex were measured by using MRI.The correlation between the volumetric changes of hippocampus and entorhinal cortex with scores of mini-mental state examination (MMSE) and Montreal Cognitive Assessment(MoCA) was analyzed.Results The volume of hippocampus and entorhinal cortex in the MCI group,AD group and NC group were (6.29 ± 1.13)cm3 and (2.71 ± 0.51) cm3,(6.27 ± 1.11) cm3 and (2.09 ±0.68) cm3,(7.01 ±0.92) cm3 and (3.12 ±0.34) cm3 respectively.The volume of MCI group was obviously smaller than that of NC group (P ＜ 0.05).The volume of AD group was smaller than that of NC group(P ＜0.01).The volume of AD group was obviously smaller than that of MCI group(P ＜0.01).There was positive correlation between hippocampus volume,the volume of entorhinal cortex and MMSE scores (r =0.770,0.811 ; P ＜ 0.01).Meanwhile,hippocampal volume,volume of entorhinal cortex were positive correlated with MoCA (r =0.810,0.842; P ＜ 0.01).Conclusion The atrophy of entorhinal cortex and hippocampus is closely related to cognitive disorder.The MRI measuring of the volume of entorhinal cortex and hippocampus has a potential value in diagnosing and distinguishing of MCI and NC.