Alzheimer病患者脑内扩大的血管周围间隙的临床意义

摘要
图/表
参考文献(13)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨Alzheimer病（Alzheimer disease，AD）患者在不同认知程度下脑内扩大的血管周围间隙（Enlarged perivascular spaces，EPVS）的变化，并进一步分析EPVS与简易精神状态检查（Mini-mental state examination，MMSE）评分之间的关系。方法：30例AD患者（AD组，MMSE＜24分）、20例轻度认知障碍患者（Mild cognitive impairment，MCI组；24分≤MMSE＜27分）以及30例年龄、性别及受教育程度相匹配的健康老年人（正常对照组，MMSE≥27分）纳入本研究，通过观察MRI T2WI及T2 FLAIR图像，计数各组基底节区及半卵圆中心区EPVS的数目并进行4级评分。用Kruskal-Wallis及Kolmogorov-Smirnov Z检验分析组间差异，同时应用Spearman相关分析各组不同脑区EPVS评分与MMSE之间的关系，以及正常对照组基底节区、半卵圆中心区EPVS评分与年龄之间是否相关。结果：三组间基底节及半卵圆中心区EPVS评分均有统计学差异（H值分别为26.45和41.4，P＜0.01）；与正常对照组相比，AD组的基底节区EPVS评分明显升高（1.06±0.25，1.80±0.71，P＜0.01），而与MCI组比较无统计学差异（1.15±0.36，P＞0.05）；在半卵圆中心区域，AD组的EPVS评分（2.93±0.83）分别高于MCI组（2.40±0.68）及正常对照组（1.40±0.50，P＜0.01）。Spearman相关分析显示基底节区、半卵圆中心EPVS评分与MMSE评分均呈负相关（r=-0.708，r=-0.594，P＜0.01），同时研究结果显示正常对照组基底节区EPVS评分与年龄存在正相关（r=0.418，P＜0.05），但是没有发现半卵圆中心区EPVS评分与年龄存在相关性（P＞0.05）。结论：基底节区、半卵圆中心EPVS在AD患者中普遍存在，并一定程度上反映了AD患者认知功能的水平。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	尚劲
	刘杨颖秋
	王微微
	宋清伟
	苗延巍

关键词 ：阿尔茨海默病, 磁共振成像

Abstract：Objective: To explore the imaging features of enlarged perivascular spaces(EPVS) in basal ganglia and centrum semiovale in mild cognitive impairment(MCI) and Alzheimer disease(AD) patients, and to analyze the relationship between EPVS and cognitive impairment． Methods: In this study, 30 patients with AD(AD group, mini-mental state examination(MMSE)<24), 20 patients with MCI(MCI group, 24≤MMSE<27) and 30 normal controls(NC group, MMSE≥27) were reviewed retrospectively. EPVS in both the basal ganglia and centrum semiovale were counted in axial images according to the following standard: 1 score for EPVS less than 10, 2 scores for EPVS between 11 to 20, 3 scores for EPVS between 21 to 40 and 4 scores for EPVS more than 40. Kruskal-Wallis test and Kolmogorov-Smirnov Z test were used to analyze the inter-group difference. Relationship between the scores of EPVS and MMSE was explored using Spearman’s correlation analyses. Results: Significantly statistical differences of EVPS score in both the basal ganglia and centrum semiovale were found among the three groups(H values respectively=26.45, 41.4, all P<0.01). In the basal ganglia, EPVS score in AD group(1.80±0.71) was higher than that in NC group(1.06±0.25)(P＜0.01), and there was no difference of EPVS scores between MCI and NC group(P>0.05). In the centrum semiovale, EPVS scores in AD group(2.93±0.83) was obviously higher than that in MCI group(2.40±0.68) and NC group(1.40±0.50, P＜0.01). There were correlations between the scores of EPVS and MMSE in both the basal ganglia and centrum semiovale(r values respectively=-0.708, -0.594, all P<0.01). Besides, in the NC group, there was correlation between the score of EPVS and MMSE in the basal ganglia(r=0.418, P＜0.05）. Conclusion: In patients with AD, EPVS is a common phenomenon in both the basal ganglia and centrum semiovale, and it can help to evaluate the changes of cognitive abilities.

Key words： Alzheimer disease Magnetic resonance imaging

收稿日期: 2016-09-22

PACS:	Ｒ749.16
	Ｒ445.2

通讯作者: 苗延巍，大连医科大学附属第一医院放射科，116011。E-mail：ywmiao716@163.com

作者简介: 尚劲（1990-），女，内蒙古呼伦贝尔人，在读硕士研究生。E-mail：345841019@qq.com

引用本文:

尚劲，刘杨颖秋，王微微，宋清伟，苗延巍. Alzheimer病患者脑内扩大的血管周围间隙的临床意义[J]. 中国临床医学影像杂志, 2017, 28(6): 387-390.
SHANG Jin, LIU Yang-ying-qiu, WANG Wei-wei, SONG Qing-wei, MIAO Yan-wei. Clinical significance of enlarged perivascular spaces in Alzheimer disease patients. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(6): 387-390.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I6/387

[1]张晓玲，尹平，张小辉，等. 阿尔茨海默病的血管周围间隙影像特征分析[J]. 磁共振成像，2015，6（11）：807-811.
[2]Makedonov I, Black SE, Macintosh BJ. Cerebral small vessel disease in aging and Alzheimer’s disease: a comparative study using MRI and SPECT[J]. Eur J Neurol, 2013, 20(2): 243-250.
[3]Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease[J]. Alzheimers Dement, 2011, 7(3): 270-279.
[4]Doubal FN, Maclullich AM, Ferguson KJ, et al. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease[J]. Stroke, 2010, 41(3): 450-454.
[5]Potter GM, Chappell FM, Morris Z, et al. Cerebral Perivascular Spaces Visible on Magnetic Resonance Imaging: development of a qualitative rating scale and its observer reliability[J]. Cerebrovasc Dis, 2015, 39(3-4): 224-231.
[6]Hommet C, Mondon K, Constans T, et al. Review of cerebral microangiopathy and Alzheimer’s disease: relation between white matter hyperintensities and microbleeds[J]. Dement Gerlatr Cogn Disord, 2011, 32(6): 367-378.
[7]Potter GM, Doubal FN, Jackson CA, et al. Enlarged perivascular spaces and cerebral small vessel disease[J]. Int J Stroke, 2015, 10(3): 376-381.
[8]Charidimou A, Martinezramirez S, Shoamanesh A, et al. Cerebral amyloid angiopathy with and without hemorrhage: evidence for different disease phenotypes[J]. Neurology, 2015, 84(12): 1206-1212.
[9]Martinez-Ramirez S, Pontes-Neto OM, Dumas AP, et al. Topography of dilated perivascular spaces in subjects from a memory clinic cohort[J]. Neurology, 2013, 80(17): 1551-1556.
[10]倪健强，蔡秀英，戴颖钰，等. 基底节区血管周围间隙扩大与非血管性认知障碍的关系[J]. 临床神经病学杂志，2015，28（1）：9-11.
[11]张卫，恽晓平，于一宁. 大脑中动脉供血区不同梗死灶所致认知障碍的特点[J]. 中国康复理论与实践，2014，20（7）：651-655.
[12]Jellinger KA. Alzheimer disease and cerebrovascular pathology: an update[J]. J Neural Transmission, 2002, 109(5-6): 813-836.
[13]Zhang X, Ding L, Yang L, et al. Brain Atrophy Correlates with Severe Enlarged Perivascular Spaces in Basal Ganglia among Lacunar Stroke Patients[J]. PLoS One, 2016, 11(2): e0149593.