脑微出血致认知障碍患者颅脑MRI表现特点分析
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摘要
目的探究脑微出血(CMBs)在颅脑磁共振成像(MRI)上的影像表现,分析CMBs发生部位、数量与认知障碍的相关性。方法对入选患者行常规头颅MRI及SWI检查,选择CMBs阳性患者(CMBs组)52例和CMBs阴性患者54(对照组),比较CMBs组患者CMBs分区情况、两组患者MoCA评分差异及不同部位CMBs数量与蒙特利尔认知评估量表(MoCA)评分的相关性。结果共检出1657个CMBs病灶,SWI对CMBs病灶的检出数量较MRI常规序列更多,且以大脑半球深部及颞叶分布最多;与对照组比较,CMBs组MoCA各维度评分及总分均显著降低,差异有统计学意义(P<0.05);Spearman相关性分析显示,CMBs总数与MoCA评分负相关(r=-0.68,P<0.05)。结论 SWI较常规MRI序列能检出更多CMBs病灶,且不同部位CMBs数量与患者认知障碍密切相关,CMBs数量越多,患者认知障碍越严重。
Objective To investigate imaging findings of cerebral microbleeds(CMBs) on brain magnetic resonance imaging(MRI), and to analyze location and number of CMBs,and its correlation with cognitive disorders. Methods The routine brain MRI and SWI were performed on the chosen patients. 52 patients with positive CMBs(CMBs group) and 54 patients with negative CMBs(control group) were selected. The CMBs partitions of patients were compared in CMBs group. The differences of MoCA scores, the correlation between CMBs quantity at different sites and the score of Montreal Cognitive Assessment(MoCA) were compared between the two groups. Results A total of 1657 CMBs lesions were detected. The detected number of CMBs lesions by SWI was more than that by MRI regular sequence. And deep cerebral hemisphere and temporal distribution were the most. Compared with those in the control group, the scores in each dimension and total scores of MoCA in the CMBs group were significantly lower(P<0.05). Spearman correlation analysis showed that the total number of CMBs was negatively correlated with MoCA score(r=-0.68, P<0.05). Conclusion Compared with routine MRI sequences,SWI can detect more CMBs lesions. And the number of CMBs at different sites is closely related to cognitive disorders of patients. The more number of CMBs, the more serious the cognitive disorders.
Objective To investigate imaging findings of cerebral microbleeds(CMBs) on brain magnetic resonance imaging(MRI), and to analyze location and number of CMBs,and its correlation with cognitive disorders. Methods The routine brain MRI and SWI were performed on the chosen patients. 52 patients with positive CMBs(CMBs group) and 54 patients with negative CMBs(control group) were selected. The CMBs partitions of patients were compared in CMBs group. The differences of MoCA scores, the correlation between CMBs quantity at different sites and the score of Montreal Cognitive Assessment(MoCA) were compared between the two groups. Results A total of 1657 CMBs lesions were detected. The detected number of CMBs lesions by SWI was more than that by MRI regular sequence. And deep cerebral hemisphere and temporal distribution were the most. Compared with those in the control group, the scores in each dimension and total scores of MoCA in the CMBs group were significantly lower(P<0.05). Spearman correlation analysis showed that the total number of CMBs was negatively correlated with MoCA score(r=-0.68, P<0.05). Conclusion Compared with routine MRI sequences,SWI can detect more CMBs lesions. And the number of CMBs at different sites is closely related to cognitive disorders of patients. The more number of CMBs, the more serious the cognitive disorders.
引文
[1]李譞婷,袁俊亮,胡文立.脑微出血的研究进展[J].中华行为医学与脑科学杂志,2017,26(11):1046-1048.
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[10]高晓嵘,高亚军,高慧,等.磁敏感加权成像对脑微出血的检测及脑微出血与认知功能障碍关系的研究[J].广西医科大学学报,2016,33(1):74-76.
[11]余晖,赵大聪,蒲伟,等.血管性认知障碍患者脑微出血的评价及其诊断价值初探[J].临床放射学杂志,2015,34(5):698-702.
[12]肖桂荣,孙新芳,王赵伟.脑微出血磁敏感加权成像检出情况及其与认知功能的关系[J].中国全科医学,2014,17(21):2532-2535.
[13]常飞燕,贾树红,谢晟,等.利用磁敏感加权成像评价老年人脑微出血与认知功能损伤的相关性[J].实用放射学杂志,2015,31(5):730-734.
[14]黄小钦,武剑.对脑微出血相关血管性认知障碍的认识[J].中国临床医生杂志,2014,42(1):10-12.
[15]乔琦,曲珍珍,王维平.脑微出血与慢性脑缺血患者的认知损害[J].国际脑血管病杂志,2018,26(10):737-738.
[2]戴若莲,李焰生.脑微出血和认知障碍的研究进展[J].中国卒中杂志,2014,9(12):1015-1019.
[3]罗应斌,李群英,张吉美,等.磁共振成像对脑小血管病脑微出血灶和认知相关性分析[J].中国全科医学,2017,20(S2):128-130.
[4]张定,韩波,江波,等.磁敏感加权成像对脑微出血的诊断价值[J].齐鲁医学杂志,2014,29(2):115-117.
[5]邹翠洁,张玉,许跃奇,等.3.0T MR磁敏感加权成像对脑微出血灶的诊断效能[J].山东医药,2015,55(47):48-50.
[6]王毓佳,陈志军,梁韬,等.磁共振成像常规序列与磁敏感加权成像对急性脑梗死患者脑微出血的诊断价值比较[J].实用心脑肺血管病杂志,2018,26(4):110-112.
[7]孙亚楠,杨阳,宫恒恒,等.脑微出血的临床表现及意义[J].中华老年心脑血管病杂志,2014,16(5):556-558.
[8]邢立红,翟飞,张敬,等.脑微出血灶与认知功能相关性的磁共振研究[J].中华老年心脑血管病杂志,2014,16(3):287-290.
[9]李萌,高立伟,董艳红.脑微出血的影像学表现与认知功能障碍的研究[J].国际神经病学神经外科学杂志,2018,45(5):296-298.
[10]高晓嵘,高亚军,高慧,等.磁敏感加权成像对脑微出血的检测及脑微出血与认知功能障碍关系的研究[J].广西医科大学学报,2016,33(1):74-76.
[11]余晖,赵大聪,蒲伟,等.血管性认知障碍患者脑微出血的评价及其诊断价值初探[J].临床放射学杂志,2015,34(5):698-702.
[12]肖桂荣,孙新芳,王赵伟.脑微出血磁敏感加权成像检出情况及其与认知功能的关系[J].中国全科医学,2014,17(21):2532-2535.
[13]常飞燕,贾树红,谢晟,等.利用磁敏感加权成像评价老年人脑微出血与认知功能损伤的相关性[J].实用放射学杂志,2015,31(5):730-734.
[14]黄小钦,武剑.对脑微出血相关血管性认知障碍的认识[J].中国临床医生杂志,2014,42(1):10-12.
[15]乔琦,曲珍珍,王维平.脑微出血与慢性脑缺血患者的认知损害[J].国际脑血管病杂志,2018,26(10):737-738.