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中华诊断学电子杂志 ›› 2015, Vol. 03 ›› Issue (03) : 159 -163. doi: 10.3877/cma.j.issn.2095-655X.2015.03.002

所属专题: 文献

影像学诊断研究

磁共振波谱在遗忘型与非遗忘型轻度认知障碍鉴别诊断中的应用价值
陈双庆1,(), 蔡庆1, 沈玉英1, 许传虓1   
  1. 1. 215001 南京医科大学附属苏州医院放射科
  • 收稿日期:2015-03-05 出版日期:2015-08-26
  • 通信作者: 陈双庆
  • 基金资助:
    国家自然科学基金(81171297)

The value of hydrogen proton magnetic resonance spectroscopy in the differential diagnosis of amnestic and non-amnestic mild cognitive impairment

Shuangqing Chen1,(), Qing Cai1, Yuying Shen1, Chuanxiao Xu1   

  1. 1. Department of Radiology, Suzhou Hospital, Nanjing Medical University, Suzhou 215001, China
  • Received:2015-03-05 Published:2015-08-26
  • Corresponding author: Shuangqing Chen
  • About author:
    Corresponding author: Chen Shuangqing, Email:
引用本文:

陈双庆, 蔡庆, 沈玉英, 许传虓. 磁共振波谱在遗忘型与非遗忘型轻度认知障碍鉴别诊断中的应用价值[J/OL]. 中华诊断学电子杂志, 2015, 03(03): 159-163.

Shuangqing Chen, Qing Cai, Yuying Shen, Chuanxiao Xu. The value of hydrogen proton magnetic resonance spectroscopy in the differential diagnosis of amnestic and non-amnestic mild cognitive impairment[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2015, 03(03): 159-163.

目的

探讨磁共振波谱(1H-MRS)在遗忘型轻度认知障碍(aMCI)与非遗忘型轻度认知障碍(naMCI)鉴别诊断中的应用价值。

方法

对明确诊断的25例aMCI患者(aMCI组)、22例naMCI患者(naMCI组)及20例认知功能正常老年人(NC组),行多体素1H-MRS检查,以左侧海马、扣带后回及额叶为兴趣区,检测N-乙酰天门冬氨酸(NAA)、谷氨酸(Glu)、肌醇(mI)及肌酸(Cr)的峰下面积。使用SPSS 17.0软件包对所测定的数据进行分析,3组间NAA/Cr、mI/Cr及Glu/Cr值的比较使用单因素方差分析,组间两两比较用最小差值显著法(LSD)进行统计分析。

结果

aMCI组和naMCI组在左侧海马的NAA/Cr值(分别为1.09±0.11、1.07±0.08)均低于NC组(1.20±0.21),差异有统计学意义(F=10.23,P<0.05);aMCI组和naMCI组在左侧扣带后回的NAA/Cr值(分别为1.02±0.09、1.07±0.10)也低于NC组(1.22±0.18),差异有统计学意义(F=8.73,P<0.05);aMCI组和naMCI组在海马与扣带后回的NAA/Cr值差异无统计学意义(F=1.54,P>0.05)。aMCI组扣带后回Glu/Cr值(0.35±0.04)低于naMCI组与NC组(0.43±0.02、0.42±0.05),差异有统计学意义(F=8.44,P<0.05);3组间的Glu/Cr值在海马和扣带后回的均差异无统计学意义(F=0.38,0.36;P>0.05)。aMCI组在海马的mI/Cr值(0.66±0.07)高于naMCI组和NC组(分别为0.39±0.04、0.41±0.04),差异有统计学意义(F=11.47,P<0.05);aMCI组在扣带后回的mI/Cr值(0.62±0.05)高于naMCI组和NC组(分别为0.42±0.03、0.44±0.04),差异有统计学意义(F=9.41,P<0.05);naMCI组在额叶区的mI/Cr值(0.58±0.04)高于aMCI组和NC组(分别为0.43±0.03、0.41±0.03),差异有统计学意义(F=7.83,P<0.05)。

结论

aMCI及naMCI组患者脑内mI及Glu代谢存在区域性的差异,1H-MRS为临床鉴别aMCI及naMCI提供了有效的依据。

Objective

To investigate the value of hydrogen proton magnetic resonance spectroscopy (1H-MRS) in the differential diagnosis of amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI).

Methods

Twenty-five cases of aMCI patients were enrolled, twenty-two cases with naMCI and twenty subjects were elderly with normal cognitive function (NC). They all received examination of 1H-MRS.The regions of interest were examined, including the left hippocampus, the posterior cingulate gyrus, and the frontal lobes.The area under the peak was determined for N-acethyl aspartate (NAA), glutamate (Glu), inositol (mI) and creatine (Cr). The ratios of NAA/Cr, Glu/Cr and mI/Cr were compared in different brain regions among the three groups with SPSS 17.0.

Results

Compared with the NC group, the ratio of NAA/Cr in the left hippocampus group was significantly lower than that in the aMCI and naMCI groups (1.09±0.11, 1.07±0.08, 1.20±0.21; t=0.247, 0.312; all P<0.05), and the ratio of NAA/Cr in the left posterior cingulate gyrus group was also significantly reduced with those in the aMCI and naMCI groups (1.02±0.09, 1.07±0.10, 1.22±0.18; t=0.442, 0.381; all P<0.05). However, no significant difference in the ratio of NAA/Cr in any brain region were observed between aMCI and naMCI groups (t=0.021, 0.036; P>0.05). The Glu/Cr ratio in the posterior cingulate gyrus of the aMCI group decreased significantly compared with that in the naMCI and NC groups (0.35±0.04, 0.43±0.02, 0.42±0.05; t=0.474, 0.405; all P<0.05). No significant difference in the Glu/Cr ratio was observed in other brain regions among the three groups (F=0.382, 0.363; all P>0.05). The mI/Cr ratio in the hippocampus was significantly bigger in the aMCI group than that in the naMCI and NC groups (0.66±0.07, 0.39±0.04, 0.41±0.04; t=0.293, 0.247; all P<0.05), and the mI/Cr ratio in the posterior cingulate gyrus was also significantly higher in the aMCI group than that in the naMCI and NC groups (0.62±0.05, 0.42±0.03, 0.44±0.04; t=0.255, 0.261; all P<0.05). The mI/Cr ratio in the frontal lobes of the naMCI group increased significantly compared with that in the aMCI and NC groups(0.58±0.04, 0.43±0.03, 0.41±0.03; t=0.174, 0.226; all P<0.05).

Conclusions

Regional differences of mI and Glu metabolism are found in brain tissues of patients with aMCI and naMCI.1H-MRS is an effective method in the differential diagnosis of aMCI and naMCI.

表1 aMCI组、naMCI组与NC组受试者临床特征比较
表2 aMCI组、naMCI组与NC组受试者1H-MRS的NAA/Cr值比较(±s)
表3 aMCI组、naMCI组与NC组受试者1H-MRS的Glu/Cr值比较(±s)
表4 aMCI组、naMCI组与NC组受试者1H-MRS的mI/Cr值比较(±s)
[1]
Petersen RC,Negash S. Mild cognitive impairment:an overview [J]. CNS Spectr, 2008, 13(1): 45-53.
[2]
Petersen RC.Mild cognitive impairment as a diagnostic entity [J]. J Inter Med, 2004, 256(3): 183-194.
[3]
Yaffe K,Petersen RC,Lindquist K, et al.Subtype of mild cognitive impairment and progression to dementia and death [J]. Dement Geriatr Cogn Disord, 2006, 22(4): 312-319.
[4]
Luck T,Luppa M,Briel S, et al.Incidence of mild cognitive impairment:a systematic review [J]. Dement Geriatr Cogn Disord, 2010, 29(2): 164-175.
[5]
Morris JC,Storandt M,Miller JP, et al.Mild cognitive impairment represents early-stage Alzheimer disease [J]. Arch Neurol, 2001, 58(3): 397-405.
[6]
沈娜娜,陈卫,赵仁亮. 轻度认知障碍与非痴呆型血管性认知功能障碍[J] .国际脑血管病杂志, 2010, 18(9): 691-695.
[7]
Modrego PJ,Fayed N,Pina MA.Conversion from mild cognitive-impairment to probable Alzheimer’s disease predicted by brain magnetic resonance spectroscopy [J] .Am J of Psychiatry, 2005, 162(4): 667-675.
[8]
Chantal S,Braun CM,Bouchard RW, et al.Similar 1H magnetic resonance spectroscopic metabolic pattern in the medial temporal lobes of patients with mild cognitive impairment and Alzheimer disease [J]. Brain Res, 2004, 1003(1-2): 26-35.
[9]
Fayed N,Davila J,Oliveros A, et al.Utility of different MR modalities in mild cognitive impairment and its use as a predictor of conversion to probable dementia [J]. Acad Radiol, 2008, 15(9): 1089-1098.
[10]
Kantarci K,Weigand SD,Petersen RC, et al.Longitudinal 1H MRS changes in mild cognitive impairment and Alzheimer’s disease [J]. Neurobiol Aging, 2007, 28(9): 1330-1339.
[11]
陈双庆,蔡庆,沈玉英, 等. 轻度认知功能损害患者扣带后回谷氨酸多体素氢质子磁共振波谱研究[J/CD]. 中华诊断学电子杂志, 2013, 1(1): 31-34.
[12]
Sailasuta N,Harris K,Tran T, et al.Minimally invasive biomarker confirms glial activation present in Alzheimer’s disease:a preliminary study [J]. Neuropsychiatr Dis Treat, 2011, 7(8): 495-499.
[13]
Franczak M,Prost RW,Antuono PG, et al.Proton magnetic resonance spectroscopy of the hippocampus in patients with mild cognitive impairment:a pilot study [J]. J Comput Assist Tomogr, 2007, 31(5): 666-670.
[14]
Walecki J,Barcikowska M,cwikla JB, et al.N-acetylaspartate, choline, myoinositol, glutamin and glutamate (glx) concentration changes in proton MR spectroscopy (1HMRS) in patients with mild cognitive impairment (MCI) [J]. Med Sci Monit, 2011, 17(12): 105-111.
[15]
Kantarci K,Petersen RC,Przybelski SA, et al.Hippocampal volumes, proton magnetic resonance spectroscopy metabolites, and cerebrovascular disease in mild cognitive impairment subtypes [J] Arch Neurol, 2008, 65(12): 1621-1628.
[16]
Garrard P,Perry R,Hodges JR.Disorders of semantic memory [J]. J Neurol Neurosurg Psychiatry, 1997, 62(5): 431-435.
[17]
Yi L,Wang J,Jia L, et al.Structural and functional changes in subcortical vascular mild cognitive impairment:a combined voxel-based morphometry and resting-state fMRI study [J]. PLoS One, 2012, 7(9): 44758.
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