常规MRI、DKI在脑梗死后认知障碍患者中的表现研究
Study on performance of routine MRI and DKI in patients with cognitive impairment after cerebral infarction
于健 1董文健 2夏建新3
作者信息
- 1. 唐山市第三医院影像科,河北 唐山 063001
- 2. 唐山市第三医院神经内科,河北 唐山 063001
- 3. 开滦总医院消化内科,河北 唐山 063001
- 折叠
摘要
目的 分析常规磁共振成像(MRI)、扩散峰度成像(DKI)在脑梗死后认知障碍患者中的表现.方法 回顾性分析2020年6月-2023年5月唐山市第三医院收治的98例脑梗死患者的临床资料,治疗出院后随访6个月,统计患者的认知情况,比较认知障碍组和认知正常组的基线资料及常规MRI、DKI参数,分析脑梗死后认知障碍的影响因素及常规MRI、DKI参数对脑梗死后认知障碍的预测效能.结果 98例患者中34例出现认知障碍.认知障碍组患者年龄大于认知正常组,脑干梗死占比及额叶FA值低于认知正常组,额叶梗死占比及脑干平均峰度(MK)、脑干平均扩散率(MD)值高于认知正常组(P＜0.05),多因素Logistic回归分析结果显示年龄(1.105～1.396)、额叶梗死(1.050～14.406)、脑干MK(1.965～16.819)、脑干MD(10.355～88.636)、额叶部分各向异性(FA)(0.110～0.944)为脑梗死后认知障碍的影响因素(P＜0.05).受试者工作曲线(ROC)结果显示常规MRI、DKI参数联合预测脑梗死后认知障碍的曲线下面积(AUC)值为0.911,明显高于单一参数(P＜0.05).结论 额叶梗死、额叶FA值下降、脑干MK及脑干MD值升高的患者更易发生脑梗死后认知障碍,可将常规MRI、DKI参数联合,以预测脑梗死后认知障碍,为脑梗死的诊疗提供参考.
Abstract
Objective To analyze the performance of conventional MRI and diffusion kurtosis imaging(DKI)in pa-tients with cognitive impairment after cerebral infarction.Methods The clinical data of 98 patients with cerebral infarc-tion admitted to our hospital from 2020.06 to 2023.05 were retrospectively analyzed.The cognitive status of the pa-tients was analyzed for 6 months after treatment and discharge,and the baseline data,routine MRI and DKI parameters of the cognitive impairment group and the cognitive normal group were compared.To analyze the influencing factors of cognitive impairment after cerebral infarction and the predictive efficacy of conventional MRI and DKI parameters.Re-sults 34 of 98 patients had cognitive impairment.The age of the cognitive impairment group was longer than that of the cognitive normal group,the proportion of brain stem infarction and the parameters of brain stem MD and frontal lobe FA were lower than those of the cognitive normal group,and the proportion of frontal lobe infarction and the pa-rameters of brain stem MK were higher than those of the cognitive normal group(P＜0.05).Multivariate Logistic re-gression analysis showed that:Age(1.105～1.396),frontal lobe infarction(1.050～14.406),brain stem MK(1.965～16.819),brain stem MD(10.355～88.636),and frontal lobe FA(0.110～0.944)were the influencing factors of cogni-tive impairment after cerebral infarction(P＜0.05).The ROC curve showed that the AUC value of conventional MRI and DKI parameters combined to predict cognitive impairment after cerebral infarction was 0.911,which was signifi-cantly higher than that of single parameter(P＜0.05).Conclusion Patients with frontal infarction,decreased brain stem MD and frontal FA parameters,and increased brain stem MK parameters are more likely to have cognitive impair-ment after cerebral infarction.Conventional MRI and DKI parameters can be combined to predict cognitive impairment after cerebral infarction and provide reference for the diagnosis and treatment of cerebral infarction.
关键词
常规MRI/扩散峰度成像/脑梗死/认知障碍Key words
Routine magnetic resonance imaging/Diffusion kurtosis imaging/Cerebral infarction/Cognitive impair-ment引用本文复制引用
出版年
2024
NETL
NSTL
万方数据