[1]王璐,陈壮军,邱龙海,等.首发脑卒中认知功能障碍的DCE-MRI影像学特征及其诊断价值[J].中国医学物理学杂志,2024,41(3):327-332.[doi:DOI:10.3969/j.issn.1005-202X.2024.03.010]
　WANG Lu,CHEN Zhuangjun,QIU Longhai,et al.DCE-MRI features of cognitive dysfunction in patients with first-episode stroke and their diagnostic value[J].Chinese Journal of Medical Physics,2024,41(3):327-332.[doi:DOI:10.3969/j.issn.1005-202X.2024.03.010]
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首发脑卒中认知功能障碍的DCE-MRI影像学特征及其诊断价值()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
41卷
期数:
2024年第3期
页码:
327-332
栏目:
医学影像物理
出版日期:
2024-03-27

文章信息/Info

Title:
DCE-MRI features of cognitive dysfunction in patients with first-episode stroke and their diagnostic value
文章编号:
1005-202X（2024）03-0327-06
作者:
王璐1; 陈壮军1; 邱龙海2; 王金本1
1.海南西部中心医院放射科， 海南 儋州 571700； 2.儋州市人民医院心内科导管室， 海南 儋州 571700
Author(s):
WANG Lu1;  CHEN Zhuangjun1;  QIU Longhai2;  WANG Jinben1
1. Department of Radiology, Hainan Western Central Hospital, Danzhou 571700, China 2. Cardio-Catheter Room, Danzhou Peoples Hospital, Danzhou 571700, China
关键词:
首发脑卒中; 认知功能障碍; 动态对比增强磁共振成像; 诊断价值; 危险度
Keywords:
Keywords: first-episode stroke cognitive dysfunction dynamic contrast-enhanced magnetic resonance imaging diagnostic value risk degree
分类号:
R816.1
DOI:
DOI:10.3969/j.issn.1005-202X.2024.03.010
文献标志码:
A
摘要:
目的：探讨动态对比增强磁共振成像（DCE-MRI）参数对首发脑卒中认知功能障碍的诊断价值，以期为临床早期评估脑卒中认知功能障碍发生风险、制定干预方案提供参考。方法：选取122例首发脑卒中患者作为研究对象，根据其是否发生认知功能障碍分为发生组（n=53）与未发生组（n=69），另选取53例非脑血管性认知功能障碍患者作为对照组，入院后均行DCE-MRI检查，比较3组及不同认知功能障碍程度患者DCE-MRI影像学参数［组织间隙-血浆速率常数（Kep）、容积转运常数（Ktrans）、细胞外间隙容积分数（Ve）、血浆容积分数（Vp）］，分析DCE-MRI影像学参数与认知功能障碍程度的相关性及诊断价值，并分析其对首发脑卒中认知功能障碍危险度的评估价值。结果：发生组与未发生组DCE-MRI定量参数Ktrans、Ve、Vp均高于对照组，发生组DCE-MRI定量参数Ktrans、Ve、Vp高于未发生组（P<0.05）；不同认知功能障碍程度患者DCE-MRI影像学参数Ktrans、Ve、Vp比较有统计学意义（P<0.05），且随着认知功能障碍程度加重，患者DCE-MRI影像学参数Ktrans、Ve、Vp明显升高；Ktrans、Ve、Vp均与认知功能障碍程度呈正相关关系（P<0.05）；DCE-MRI定量参数Ktrans、Ve、Vp联合诊断的AUC为0.921，明显较单独指标高（P<0.05）；DCE-MRI参数Ktrans、Ve、Vp高水平者认知功能障碍发病风险分别是低水平的3.077、1.944、2.313倍。结论：DCE-MRI可用于首发脑卒中认知功能障碍诊断，为临床早期预测卒中后认知功能障碍提供参考依据。
Abstract:
Abstract: Objective To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters for cognitive dysfunction in first-episode stroke, thereby providing reference for the early clinical assessment of the risk of cognitive dysfunction in stroke and formulation of intervention programs. Methods A total of 122 patients with first-episode stroke were enrolled and divided into occurrence group (n=53) and non-occurrence group (n=69) according to whether they had cognitive dysfunction. Additionally, 53 patients with non-cerebrovascular cognitive dysfunction were selected as control group. All patients underwent DCE-MRI examination after admission. The 3 groups and patients with different degrees of cognitive dysfunction were compared for DCE-MRI parameters, including interstitium-to-plasma rate constant (Kep), volume transfer constant (Ktrans), volume fraction of extravascular extracellular space (Ve), and volume fraction of plasma (Vp). The correlations of DCE-MRI parameters with the degree of cognitive dysfunction were analyzed, along with their diagnostic value for cognitive dysfunction and evaluation value for the risk of cognitive dysfunction after first-episode stroke. Results Both occurrence group and non-occurrence group had higher levels of Ktrans, Ve and Vp than control group, and these parameters were higher in occurrence group than non-occurrence group (P<0.05). Ktrans, Ve and Vp of patients with different degrees of cognitive dysfunction differed significantly (P<0.05), and they were increased significantly with the aggravation of cognitive dysfunction. Ktrans, Ve and Vp were all positively correlated with the degree of cognitive dysfunction (P<0.05). The AUC for the combined diagnosis using Ktrans, Ve and Vp was 0.921, significantly higher than single index (P<0.05). The risks of cognitive dysfunction in first-episode stroke patients with higher levels of Ktrans, Ve and Vp were 3.077, 1.944 and 2.313 times of the low-level, respectively. Conclusion DCE-MRI can be used to diagnose cognitive dysfunction in first-episode stroke, providing reference for early clinical prediction of cognitive dysfunction after stroke.

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备注/Memo

备注/Memo:
【收稿日期】2023-10-14 【基金项目】海南省卫生健康行业科研项目（20A200416） 【作者简介】王璐，主管技师，研究专业：医学影像技术，E-mail: wanglu58000@163.com
更新日期/Last Update: 2024-03-27