摘要
目的 探讨脑CT灌注成像(CTP)诊断抑郁症的价值及与认知功能的相关性.方法 选择2021 年3 月至2024 年2 月我院收治的80 例抑郁症患者作为抑郁症组,选择同期进行健康体检者80 例作为对照组.两组均行脑CTP检查,并采用蒙特利尔认知评定量表(MoCA)评估两组的认知功能,比较两组脑CTP参数[局部脑血流量(rCBF)、局部脑血容量(rCBV)、达峰时间(TIP)及左右额叶、左右枕叶、左右颞叶、左右顶叶CT值],绘制受试者工作特征(ROC)曲线图,计算曲线下面积(AUC),分析脑CTP诊断抑郁症的价值,并分析其与认知功能的相关性.结果 抑郁症组的左额叶、右额叶CT值、MoCA评分均低于对照组(t=7.336、7.557、30.997,均P＜0.001);两组rCBF、rCBV、TIP以及左右枕叶、左右颞叶、左右顶叶的CT值比较,差异均无统计学意义(均P＞0.05).分析ROC曲线显示,右额叶、左额叶CT值与右额叶和左额叶CT值联合诊断抑郁症的AUC为0.800、0.793、0.890,在Cut-off值为33.965、33.920 HU时可获得最佳诊断效能,且右额叶和左额叶CT值联合诊断的价值较右额叶CT值或左额叶CT值单一诊断高.抑郁症患者的右额叶、左额叶CT值与MoCA评分呈正相关(r=0.848、0.795,均P＜0.001).结论 脑CTP诊断抑郁症的价值较高,患者的右额叶、左额叶CT值与其认知功能呈正相关.
Abstract
Objective To explore the value of cerebral CT perfusion imaging(CTP)in diagnosing depression and its correlation with cognitive function.Methods A retrospective analysis was conducted to collect data from 80 patients with depression admitted to our hospital from March 2021 to February 2024,who were included in the depression group.Additionally,data from 80 healthy individu-als who underwent physical examinations during the same period were collected and included in the control group.Both groups under-went brain CTP examination and their cognitive function was evaluated using the Montreal Cognitive Assessment Scale(MoCA).Com-pare two sets of brain CTP parameters[regional cerebral blood flow(rCBF)regional cerebral blood volume(rCBV),time to peak(TIP),and CT values of left and right frontal lobes,left and right occipital lobes,left and right temporal lobes,and left and right parie-tal lobes],MoCA scores,draw receiver operating characteristic(ROC)curves,calculate area under the curve(AUC),analyze the di-agnostic value of brain CTP for depression,and analyze its correlation with cognitive function.Results The CT values and MoCA scores of the left and right frontal lobes in the depression group were lower than those in the control group(t=7.336,7.557,30.997,all P＜0.001);There were no statistically significant difference(all P＞0.05)in the CT values of rCBF,rCBV,TIP,left and right oc-cipital lobes,left and right temporal lobes,and left and right parietal lobes between the two groups.ROC curve analysis showed that the AUC of right frontal lobe and left frontal lobe CT combined with right frontal lobe and left frontal lobe CT in the diagnosis of depression were 0.800,0.793 and 0.890,and the best diagnostic efficiency was obtained when the Cut-off value was 33.965 and 33.920 HU.The combined diagnosis value of right frontal lobe and left frontal lobe CT is higher than that of right frontal lobe CT or left frontal lobe CT alone.The right and left frontal CT values were positively correlated with MoCA scores in depressed patients(r=0.848,0.795,both P＜0.001).Conclusion Brain CTP has high diagnostic value for depression,and the CT values of the right and left frontal lobes of patients are positively correlated with their cognitive function.
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