影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1328-1333.DOI: 10.7517/issn.1674-0475.220719

• 综述与论文 • 上一篇    下一篇

多模态MRI参数联合甲状腺激素评估脑小血管病认知损害的研究

王欣丽1, 甄娜1, 杨海龙2, 朱建国1   

  1. 1. 衡水市人民医院神经内一科, 河北 衡水 053000;
    2. 衡水市人民医院胸外科, 河北 衡水 053000
  • 收稿日期:2022-07-15 出版日期:2022-11-23 发布日期:2022-11-15
  • 通讯作者: 朱建国
  • 基金资助:
    2021年河北省卫生健康委医学科学研究课题(20211563)

Multimodal MRI Parameters Combined with Thyroid Hormones to Assess Cognitive Impairment in Cerebral Small Vessel Disease

WANG Xinli1, ZHEN Na1, YANG Hailong2, ZHU Jianguo1   

  1. 1. No.1 Department of Neurology, Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China;
    2. Department of Thoracic Surgery, Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China
  • Received:2022-07-15 Online:2022-11-23 Published:2022-11-15

摘要: 本文探讨多模态磁共振成像(MRI)技术联合甲状腺激素评估脑小血管病(CSVD)认知损害价值及临床意义。根据是否伴有认知损害,将112例CSVD患者分为损害组(n=49)、无损害组(n=63),比较两组患者多模态MRI参数[脑白质病变(WMLs)评分、WMLs体积、脑微出血(CMBs)数量、各向异性(FA)值、表观扩散系数(ADC)值]、甲状腺激素[甲状旁腺激素(PTH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)]。结果显示,损害组WMLs评分、WMLs体积、CMBs数量高于无损害组,基底节区、顶叶、额颞叶FA值低于无损害组(P<0.05);损害组PTH、TSH高于无损害组,T3、T4低于无损害组(P<0.05);WMLs评分、WMLs体积、CMBs数量、基底节区FA值、顶叶FA值、额颞叶FA值联合PTH、T3、T4、TSH评估CSVD认知损害的AUC大于任一单一指标;WMLs评分、WMLs体积、CMBs数量及PTH、TSH与MMSE评分呈负相关(P<0.001);基底节区、顶叶、额颞叶FA值及T3、T4与MMSE评分呈正相关(P<0.001)。多模态MRI参数、甲状腺激素与CSVD认知损害及其严重程度有关,联合检测可作为评估患者认知损害状况的有效方案之一。

关键词: 多模态MRI技术, 甲状腺激素, 脑小血管病, 认知损害

Abstract: This paper investigated the value and clinical significance of multimodal magnetic resonance imaging (MRI) technique combined with thyroid hormone to assess cognitive impairment in cerebral small vessel disease (CSVD). According to the presence or absence of cognitive impairment, the 112 patients with CSVD were divided into damaged group (n=49) and non-damaged group (n=63). The multimodal MRI parameters [white matter lesions (WMLs) score, volume of WMLs, number of cerebral microhemorrhages (CMBs), fraction anisotropy (FA) values, apparent diffusion coefficient (ADC) values], thyroid hormones [parathyroid hormone (PTH), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH)] were compared between the two groups. The results showed that WMLs scores, WMLs volume, and CMBs number in the damaged group were higher than in the non-damaged group, and FA values in the basal ganglia area, parietal lobe, and frontotemporal lobe were lower than in the non-damaged group (P<0.05). PTH and TSH in the damaged group were higher than in the non-damaged group, and T3 and T4 were lower than in the non-damaged group (P<0.05). AUC of WMLs score, volume of WMLs, number of CMBs, FA value of basal ganglia area, FA value of parietal lobe, FA value of frontotemporal lobe combined with PTH, T3, T4 and TSH to assess cognitive impairment in CSVD was greater than any single index; WMLs score, volume of WMLs, number of CMBs and PTH and TSH were negatively correlated with MMSE score (P<0.001). Basal ganglia area, parietal and frontotemporal FA values and T3 and T4 were positively correlated with MMSE scores (P<0.001). Multimodal MRI parameters and thyroid hormones are associated with CSVD cognitive impairment and its severity, and the combined test can be one of the effective protocols to assess the cognitive impairment status of patients.

Key words: multimodal MRI technique, thyroid hormone, cerebral small vessel disease, cognitive impairment