Department of Neurology, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China.
Emergency Department, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China.
Contrast Media Mol Imaging. 2022 Sep 30;2022:5238941. doi: 10.1155/2022/5238941. eCollection 2022.
Through the case control study on structural magnetic resonance imaging (sMRI) scanning, MR spectrum (MRS), and neuropsychological assessment of the intracranial structures of Alzheimer's disease (AD), patients of different degrees (early, middle, and late), the early clinical features, imaging features, and neuropsychological characteristics of patients with AD were analyzed to provide help for the early diagnosis of AD. The data of MR scanning of the brain, bilateral MRS scan of the hippocampus, thyroid function and other laboratory indicators, and neuropsychological evaluation analysis were collected in 50 patients who had been diagnosed with AD. According to CDR, 50 patients were divided into the early AD group and the middle and advanced AD group, with 23 patients in the early AD group and 27 patients in the middle and advanced AD group. Retrospective study was conducted to analyze the general conditions, medial temporal lobe atrophy (MTA) grading, and the metabolic changes of bilateral MRS in the hippocampus of patients in both groups, so did the mini-mental state examination (MMSE), activities of daily living scale (ADL), and other neuropsychological assessment results. Moreover, the comparative analysis was carried out. The results showed that the MTA grade of medial temporal atrophy increased with the progressive severity of the disease in both groups. A statistical test was conducted on the reduction of hippocampal volume in the two groups, and the P was less than 0.05. Therefore, the MTA scale was of great value in the diagnosis and staging of early AD. However, when the diagnosis of early AD was treated by MTA visual evaluation alone, there was 23.8% false negative diagnosis. If the judgment of early AD only depended on the metabolic changes of hippocampus MRS or MR scanning of intracranial structures, it was likely to cause false negative diagnosis. Therefore, the combination of MRS analysis and MR scanning of intracranial structures was favorable for the early diagnosis and treatment of AD. Combined with neuropsychological assessment, AD patients were staged more effectively, which greatly improved the accuracy of AD diagnosis in the early stage.
通过对阿尔茨海默病（AD）患者颅内结构的结构磁共振成像（sMRI）扫描、磁共振波谱（MRS）和神经心理学评估的病例对照研究，分析不同程度（早期、中期和晚期）患者的早期临床特征、影像学特征和神经心理学特征，为 AD 的早期诊断提供帮助。收集了 50 例已确诊 AD 患者的脑部 MR 扫描、双侧海马 MRS 扫描、甲状腺功能等实验室指标和神经心理学评估分析数据。根据 CDR，将 50 例患者分为早期 AD 组和中晚期 AD 组，早期 AD 组 23 例，中晚期 AD 组 27 例。回顾性分析两组患者一般情况、内侧颞叶萎缩（MTA）分级及双侧海马 MRS 代谢变化，同时进行简易精神状态检查（MMSE）、日常生活活动量表（ADL）等神经心理学评估结果，并进行对比分析。结果显示，两组患者的内侧颞叶萎缩 MTA 分级随疾病严重程度的进展而增加。对两组海马体积减少进行统计学检验，P＜0.05。因此，MTA 分级对早期 AD 的诊断和分期具有重要价值。但是，当单纯通过 MTA 视觉评估对早期 AD 进行诊断时，有 23.8%的误诊。如果单纯根据海马 MRS 代谢变化或颅内结构 MR 扫描对早期 AD 进行判断，可能会导致误诊。因此，MRS 分析与颅内结构 MR 扫描相结合有利于 AD 的早期诊断和治疗。结合神经心理学评估，更有效地对 AD 患者进行分期，大大提高了早期 AD 诊断的准确性。
