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目的研究脑梗死患者白质疏松的磁共振波谱表现特点,以及白质疏松的磁共振波谱与认知功能的关系,为血管性认知功能障碍的早期识别及防治提供依据。方法选择51例脑梗死伴白质疏松患者及21例非白质疏松者进行简易智能状态测验(MMSE)、画钟试验测试、Fuld物体记忆测验(FOM)、快速词汇测验(RVR)及WAIS数字广度测验;同时行头颅磁共振成像(MRI)及双侧额叶白质的磁共振波谱(MRS)检查,测定N-乙酰天门冬氨酸(NAA)、肌酸(Cr)及胆碱(Cho)的浓度。分析白质疏松的MRS表现特点及其与认知功能障碍的关系。结果重度脑白质疏松组Cho/Cr值明显高于无、轻及中度疏松组;Cho/Cr值与白质疏松程度呈正相关;左侧额叶白质NAA/Cr值与MMSE评分及画钟试验评分正相关;右侧Cho/Cr值与WAIS数字广度测验评分负相关。结论双侧额叶白质区MRS改变主要为Cho/Cr值升高,并且与白质疏松程度正相关。血管性认知障碍与双额叶白质区神经纤维损害不一定完全一致。
Objective To study the characteristics of white blood cell (MR) magnetic resonance spectroscopy in patients with cerebral infarction and the relationship between MRS and cognitive function in patients with cerebral infarction and provide the basis for early identification and prevention of vascular cognitive dysfunction. Methods Fifty-one patients with cerebral infarction and osteoporosis and 21 non-leukoaraiosis patients were selected for MMSE, FOH, FMR, RVIS and WAIS digit breadth test The concentrations of N-acetyl-aspartate (NAA), creatine (Cr) and choline (Cho) were measured by magnetic resonance imaging (MRS) and magnetic resonance spectroscopy (MRS) . To analyze the characteristics of MRS and its relationship with cognitive dysfunction in patients with leukoaraiosis. Results The Cho / Cr value of severe leukoaraiosis group was significantly higher than that of no, mild and moderate osteoporosis group. Cho / Cr value was positively correlated with the degree of leukoaraiosis. NAA / Cr value of left frontal lobe white matter was significantly correlated with MMSE score and draw bell test score Positive correlation; the right Cho / Cr value and WAIS digital breadth test negative correlation. Conclusions The change of MRS in bilateral frontal white matter is mainly due to the increase of Cho / Cr, which is positively correlated with the degree of white matter. Vascular cognitive impairment is not necessarily the same as nerve fiber damage in the bilateral frontal white matter.