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当代阿耳茨海默病研究

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ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

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Research Article

阿尔茨海默氏症、血管性痴呆和混合性痴呆的血管损伤和脑萎缩：优化的3T MRI方案揭示了独特的放射学特征

卷 19, 期 6, 2022

发表于: 04 August, 2022

页: [449 - 457] 页: 9

弟呕挨: 10.2174/1567205019666220620112831

价格: $65

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摘要

背景：血管损伤可能也是阿尔茨海默氏痴呆症的常见发现，但其对认知状态的作用尚不确定。 目的：本研究旨在调查其在阿尔茨海默氏症、血管性痴呆或混合性痴呆患者中的分布，并检测任何独特的神经放射学特征。 方法：76名受试者被诊断为阿尔茨海默病（AD=32）、血管性痴呆（VD=26）和混合性痴呆（MD=18）。三位独立的评估者使用血管病变（脑室周围病变（PVL）、深白质病变（DWML）、深灰质病变（DGML）、扩大的血管周围间隙（PVS））的半定量量表，评估了通过优化的3T MRI方案（包括（3D FLAIR、T1、SWI和2D冠状T2序列）采集的脑图像，和微出血（MB））和脑萎缩（内侧颞叶萎缩（MTA）、后部萎缩（PA）、全局皮质萎缩-额叶（GCA-F）和Evans指数）。 结果：Raters在所有量表中都达到了良好到极好的一致性（ICC范围为0.78-0.96）。与AD相比，VD中观察到更多的PVL（p<0.001）、DWML（p<0.001）、DGML（p=0.010）和PVS（p=0.001），而MD显示PVL（p=0.001）、DML（p=0.002）、DGML（p=0.01 8）以及深部和近部MB（分别为p=0.006和p<0.001。与VD和MD相比，VD显示基底节和半卵圆中心PVS的数量更高（p=0.040），而MD显示更深和更近的MB（分别为p=0.042和p=0.022）。三组间皮质萎缩量表和Evans指数评分无显著差异。 结论：通过更准确地检测血管病变（主要是微出血），所提出的MRI方案在认知障碍患者的诊断评估中代表了一个有用的进步，而不会显著增加时间和资源支出。我们的发现证实，白质和灰质病变在血管性痴呆和混合性痴呆中占主导地位，而深部和边缘微出血在混合性痴呆患者中占主导，这表明大脑淀粉样血管病可能是主要的潜在病理。

关键词: 阿尔茨海默氏痴呆、血管性痴呆、混合性痴呆、白质病变、微出血、视觉评分

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