皮层下缺血患者认知功能评估与功能磁共振的的研究

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1、温州医学院硕士学位论文ADc值升高(尺0．05)。FA值的降低以额叶、半卵圆区最明显。ADC值升高以颞叶最明显。结论VCI患者在额叶、半卵圆区FA值明显降低，存在纤维束的破坏。第三部分皮层下缺血患者的磁共振波谱分析目的利用磁共振质子波谱分析(躲S)技术探讨皮层下缺血(SIvD)导致认知功能障碍患者的影像学特征。方法52例皮层下缺血性脑血管病患者经认知量表评分后32例有认知障碍归入血管性认知功能障碍(VCI)组，20例无认知障碍作为对照组，完成MRS检查。测定右侧额叶和左侧颞叶N-乙酰基天门冬氨酸(NAA)、肌酸复合物(

2、Cr)、含胆碱化合物(Cho)，肌醇(mI)的峰值。结果在额叶VCI组与对照组相比NAA／Cr值明显降低(1．43±0．08VS1．53±0．92)，在颞叶VCI组mI／Cr值升高(O．51±O．06vs0．46+O．07)，有统计学意义(P(0．05)。结论VCI患者额叶白质区NAA值明显降低，存在额叶的代谢功能改变。关键词认知皮层下缺血弥散张量成像波谱英文摘要FunctionalMRIpredictorsofcognitioninsubcorticalischemicvasculardiseaseAbstractV

3、ascularcognitiveimpairment(vcoisaheterogeneousgroupofcognitivedisordersthatshareapresumedvascularcause．In2003，O’BrienandcolleagueslproposedthatpeoplewithVCIhaveaspecificcognitiveprofileinwhichmemory1spreservedandexecutivefunctionimpaired，thatdiagnosticcriteriawe

4、reforthcoming．andthatclinicaltrialswereneeded．Subcorticalischemicvasculardisease(SlVD)isacommon,butoftenoverlookedcauseofvascularcognitiveimpairment．Thecognitivedomainsaffectedbyleukoaraiosisarenotcleadvestablished，buttheassociationwithcognitiveandfunctionaldecl

5、ineisrobust．DiffusiontensorMRI∞TDisanewtechniquethatprovidesquantitativeinformationaboutdisruptionofwhitematterprojections．Protonmagneticresonancespectroscopy(1H-MRS)allowsmajormetabolitestobemeasurednoninvasivelyindefinedregionsofthelivingbrain．Withthesenewtech

6、nologieswecanseethestructuralandmetabolicbrainchangesthatoccuramongpatientswithsubcorticalischemicvasculardementiaMRI-definedsubcorticalischemicvasculardisease：baselineclinicalandneuropsychOlOgicalfindingsObjectiveTodescribetheclinicalandcognitivecharacteristics

7、oftheMRI-definedSIVDinamixedsampleoffunctionallyindependentelderlysubjects．Methods52subjectsmeetingtheSIVDimagingcriteriaunderwentcomprehensiveclinicalandneuropsychologicalexaminations，32withcognitiveimpairmentcomparedtO20withoutcognitiveimpairment．ResultsVClwas

8、associatedwithlowereducation,hypertensionand,independently，withmierobleeding．VCIsubjectsperformedsignificantlyinferiorlyintestsofe丑obalcognitivefunction,psychomotorsp