轻度认知障碍和阿尔茨海默病患者扣带回<sup>1</sup>H-MRS的对照研究-东南大学学报医学版

轻度认知障碍和阿尔茨海默病患者扣带回¹H-MRS的对照研究

单位：1. 南京医科大学鼓楼临床医学院医学影像科, 江苏南京 210008;
2. 南京大学医学院附属鼓楼医院神经内科, 江苏南京 210008;
3. 南京医科大学鼓楼临床医学院神经内科, 江苏南京 210008;
4. 南京大学医学院附属鼓楼医院医学影像科, 江苏南京 210008

关键词：阿尔茨海默病轻度认知障碍多体素氢质子波谱扣带回

分类号：R749.16

出版年·卷·期（页码）：2015·34·第五期（775-778）

摘要：

目的:探讨轻度认知障碍(MCI)和阿尔茨海默病(AD)患者扣带回代谢物的改变及分布规律,以帮助理解疾病病理改变。方法:使用Achieva 3.0 T TX双梯度双射频源磁共振成像系统、SENSE-8-HEAD线圈,对性别、年龄和教育程度匹配的20例AD患者(AD组)、25例MCI患者(MCI组)及22例正常老年人(对照组,NC组)进行双侧扣带回多体素2D-PRESS ¹H-MRS扫描。比较3组间双侧扣带回的N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、肌醇(MI)/Cr、MI/NAA值的差异。结果:3组比较只有MI/Cr值的差异有统计学意义,组间比较提示MCI组和AD组的MI/Cr值均高于NC组(P<0.05),AD组的MI/NAA值高于NC组(P<0.05),NAA/Cr值3组间差异未见统计学意义。扣带回MI/Cr值与MoCA评分呈显著负相关,MI/NAA值与MMSE评分呈负相关。结论:在AD和MCI患者中扣带回MI/Cr值明显升高,与认知功能呈负相关,MI变化较NAA变化更早更明显,有助于AD早期诊断。

Objective: To investigate the metabolic changes and the metabolites distribution of cingulate gyrus in patients with mild cognitive impairment(MCI) and Alzheimer's disease(AD),in order to help understand the pathological process. Methods: MRI examinations were performed at 3 Teslas using an SENSE-8-channel phased array coil (Achieva 3.0 T TX dual gradient and dual-source parallel RF excitation and transmission technology).2D-PRESS ¹H-MRS in bilateral cingulate gyri was employed in 20 patients of same gender, similar ages and educational backgrounds with AD,25 patients with MCI,and 22 normal controls(NC group).The ratios of-acetylaspartate(NAA)/creatine(Cr), myoinositol(mI)/creatine and myoinositol/N-acetylaspartate were compared between groups. Results: Among the 3 groups, the MI/Cr was the only one with statistically significant difference. The MI/Cr in MCI and AD were higher than that of the NC groups; and the MI/MAA of the AD group was significantly higher than that of the NC group(P<0.05). NAA/Cr was not significantly different among the three groups.MI/Cr from cingulate gyrus was significantly negatively correlated with MoCA, and MI/NAA was significantly negatively correlated with MMSE. Conclusion: The MI/Cr values from cingulate gyrus in AD and MCI are significantly higher than the NC group and are negatively correlated with the score of cognitive function, indicating that MI changes earlier and more obviously than NAA,which might be helpful for earlier diagnosis of AD.

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