老年人脑结构的ASL灌注加权成像观测及临床应用

doi:10.13418/j.issn.1001-165x.2025.4.10

PDF(1053 KB)

中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (4) : 421-425. DOI: 10.13418/j.issn.1001-165x.2025.4.10

断层影像解剖

老年人脑结构的ASL灌注加权成像观测及临床应用

苗莹莹¹，付钰蕾¹，李培²，李品品²，岳学强³，付升旗³*

作者信息 +

Arterial spin labeling perfusion weighted imaging observation of the elderly brain structure and its clinical application

Miao Yingying¹, Fu Yulei¹, Li Pei², Li Pinpin², Yue Xueqiang³, Fu Shengqi³*

Author information +

文章历史 +

摘要

目的为阿尔茨海默病（AD）的早期诊断提供新的影像诊断依据。方法选取动脉自旋标记（ASL）灌注加权成像检查的60名不同年龄阶段检查正常老年人和60例不同程度AD老年患者，在图像后处理工作站划分脑结构的感兴趣区（ROI），测量ROI的脑血流量（CBF）值。比较不同年龄阶段老年人脑结构ROI及其与AD患者相应ROI的CBF值。结果不同年龄阶段老年人的扣带回、海马旁回、海马、额叶眶部、颞叶颞极、岛叶、杏仁体的CBF值均有统计学意义（P<0.05），且ROI脑结构的CBF值均随着年龄增大而逐渐降低。观测组的扣带回、海马旁回、海马、额叶眶部、颞叶颞极、岛叶、杏仁体的CBF值分别为（56.49±5.73） mL/100g·min、（49.40±3.51） mL/100g·min、（46.57±4.27） mL/100g·min、（58.59±4.67）mL/100g·min、（57.66±4.80） mL/100g·min、（56.47±3.79） mL/100g·min、（45.61±3.53） mL/100g·min，与轻、中、重度AD老年患者相应ROI脑结构的CBF值均有统计学意义（P<0.05），且ROI脑结构的CBF值随着AD病情加重而逐渐降低。结论边缘系统的海马、扣带回等是AD患者脑结构中的血流低灌注部位，ASL灌注加权成像在大脑皮质萎缩之前的CBF 值可以早期反映AD患者脑结构的功能情况。

Abstract

Objective To provide new imaging diagnostic basis for the early diagnosis of Alzheimer's disease (AD). Methods Sixty normal old people with check of different ages and 60 elderly AD of different degrees were selected by arterial spin labeling(ASL) perfusion weighted imaging examination. At the image post-processing workstation, the regions of interest (ROI) of brain structure were divided, and the cerebral blood flow (CBF) value of ROI was measured. The CBF values of brain structure ROI among the different old ages groups and its corresponding ROI in AD group were compared. Results There were statistically significant in the CBF values among of the different old ages group of the cingulate gyrus, parahippocampal gyrus, hippocampus, orbital part of frontal lobe, temporal pole of temporal lobe, insula lobe and amygdaloid body in all age groups (P<0.05), and the CBF value of ROI decreased gradually with the increase of age. The CBF values in the observation group of the cingulate gyrus, parahippocampal gyrus, hippocampus, orbital part of frontal lobe, temporal pole of temporal lobe, insula lobe and amygdaloid body were (56.49±5.73) mL/100g·min, (49.40±3.51) mL/100g·min, (46.57±4.27) mL/100g·min, (58.59±4.67) mL/100g·min, (57.66±4.80) mL/100g·min, (56.47±3.79) mL/100g·min, (45.61±3.53) mL/100g·min, respectively. There were statistically significant in the CBF value of ROI among the observation group and the mild, moderate, severe old AD group (P<0.05), and the CBF value of ROI decreased gradually with the severity of AD lesion. Conclusions The hippocampus and cingulate gyrus of limbic system are the hypoperfusion sites in the brain structure of AD patients, the CBF value of ASL perfusion weighted imaging before cerebral cortex atrophy can reflect the function of brain structure in AD patients.

导出引用

苗莹莹, 付钰蕾, 李培, 李品品, 岳学强, 付升旗. 老年人脑结构的ASL灌注加权成像观测及临床应用[J]. 中国临床解剖学杂志. 2025, 43(4): 421-425 https://doi.org/10.13418/j.issn.1001-165x.2025.4.10

Miao Yingying, Fu Yulei, Li Pei, Li Pinpin, Yue Xueqiang, Fu Shengqi. Arterial spin labeling perfusion weighted imaging observation of the elderly brain structure and its clinical application[J]. Chinese Journal of Clinical Anatomy. 2025, 43(4): 421-425 https://doi.org/10.13418/j.issn.1001-165x.2025.4.10

中图分类号： R445.2

参考文献

[1] 白桂芹，肖如辉，陈莉，等. 阿尔茨海默病患者海马结构的断层影像学研究 [J]. 中国临床解剖学杂志, 2020, 38(1): 29-34. DOI: 10.13418/j.issn.1001-165x.2020.01.007.
Bai GQ, Xiao RH, Chen L, et al. Sectional imaging study of the hippocampus in patients with alzheimer's disease [J]. Chin J Clin Anat, 2020, 38(1): 29-34. DOI: 10.13418/j.issn.1001-165x.2020.01.007.
[2] 贺元彦，邵佳，贺业新. 三维动脉自旋标记在评价健康成人脑血流的应用研究[J]. 中国药物与临床, 2021, 21(19): 3213-3216. DOI: 10.11655/zgywylc2021.19.002.
He YY, Shao J, He YX. Use of 3D-ASL in evaluation of normal adult cerebral blood flow [J]. Chinese Remedies & Clinics, 2021, 21(19): 3213-3216. DOI: 10.11655/zgywylc2021.19.002.
[3] 冯伦伦，金蓉，曹城浩，等. 阿尔茨海默病患者认知功能减退的海马亚区结构改变分析 [J]. 临床放射学杂志, 2022, 41(10): 1819-1824. DOI: 10.13437/j.cnki.jcr.2022.10.025.
Feng LL, Jin R, Cao CH, et al. Structural changes in the hippocampal subfieldsabout cognitive decline of Alzheimer's disease [J]. Journal of Clinical Radiology, 2022, 41(10): 1819-1824. DOI: 10.13437/j.cnki.jcr.2022.10.025.
[4] Dubois B, Feldman HH, Jacova C, et al. Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria [J]. Lancet Neurol, 2007, 6(8): 734-746. DOI: 10.1016/S1474-4422(07)70178-3.
[5] 陈旭明．尼莫地平联合多奈哌齐对老年痴呆患者阿尔茨海默病评分及MMSE评分的影响及疗效[J]. 数理医药学杂志，2019, 32(5): 755-756. DOI: 10.3969/j.issn.1004-4337.2019.05.057.
Chen XM. Effect of Nimodipine combined with Donepezil on Alzheimer's disease score and MMSE score in senile dementia patients [J]. Journal of Mathematical Medicine, 2019, 32(5): 755-756.DOI: 10.3969/j.issn. 1004-4337.2019.05.057.
[6] 唐富强，王成伟，尹喜. 阿尔茨海默病脑血流灌注特点与认知功能的相关性研究[J]. 中国CT和MRI杂志, 2018, 16(1): 1-4. DOI: 10.3969/j.issn.1672-5131.2018.01.001.
Tang FQ, Wang CW, Yin X. Study on the correlation between cerebral blood perfusion characteristics and cognitive function in Alzheimer's disease [J]. Chinese Journal of CT and MRI, 2018, 16(1): 1-4. DOI: 10.3969/j.issn.1672-5131.2018.01.001.
[7] Sang YK, Young CY, Ging-Yuek RH, et al. Voxel-based morphometric study of brain volume changes in patients with Alzheimer's disease assessed according to the Clinical Dementia Rating score [J]. J Clin Neurosci, 2011, 18(7): 916-921. DOI: 10.1016/j.jocn.2010.12.019.
[8] 金平，林敏，钱琦，等. 正常老年人主要脑功能区血流灌注的3D-ASL初探 [J]. 浙江中医药大学学报, 2015, 39(4): 282-285. DOI: 10.16466/j.issn1005-5509.2015.04.012.
Jin P, Lin M, Qian Q, et al. Preliminary study of magnetic resonance 3D-ASL perfusion in the aged cerebral functional areas [J]. Journal of Zhejiang Chinese Medical University, 2015, 39(4): 282-285. DOI: 10.16466/j.issn1005-5509.2015.04.012.
[9] Soni N, Jain A, Kumar S, et al. Arterial spin labeling magnetic resonance perfusion study to evaluate the effects of age and gender on normal cerebral blood flow [J]. Neurol India, 2016, 64(1): 32-38. DOI: 10.4103/0028-3886.178037.
[10]Mathijs B, Michelle B, Michael S, et al. The value of arterial spin labelling perfusion MRI in brain age prediction [J]. Hum Brain Mapp, 2023, 44(7): 2754-2766. DOI: 10.1002/hbm.26242.
[11] 王子含，闫少珍，崔碧霄，等. 动脉自旋标记成像技术联合认知评分诊断阿尔茨海默病研究 [J]. 中华老年心脑血管病杂志, 2022, 24(2): 171-175. DOI: 10.3969/j.issn.1009-0126.2022.02.016.
Wang ZH, Yan SZ, Cui BX, et al. Application of arterial spin-labeled imaging combined with cognitive score in diagnosis of AD [J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases，2022, 24(2): 171-175. DOI: 10.3969/j.issn.1009-0126.2022.02.016.
[12]Desikan RS, Cabral HJ, Settecase F, et al. Automated MRI measures predict progression to Alzheimer’s diseas [J]. Neurobiol Aging, 2010, 31(8): 1364-1374. DOI: 10.1016/j.neurobiolaging.2010.04.023.
[13]曾祥柱，袁慧书，刘颖，等. 基于体素的轻度阿尔茨海默病脑血流灌注及脑灰质结构特征[J]. 中国医学影像学杂志, 2017, 25(2): 81-85. DOI: 10.3969/j.issn.1005-5185.2017.02.001.
Zeng XZ, Yuan HS, Liu Y, et al. Characteristics of cerebral blood flow and cerebral gray matter in patients with mild Alzheimer's disease using voxel-based method [J]. Chinese Journal of Medical Imaging, 2017, 25(2): 81-85. DOI: 10.3969/j.issn.1005-5185.2017.02.001.