采用MP2RAGE序列测量T1弛豫时间及经颅多普勒评估急性脑梗死患者的认知功能障碍及脑血流动力学
Assessment of cognitive impairment after acute cerebral infarction with T1 relaxation time measured by MP2RAGE sequence and cerebral hemodynamic by transcranial Doppler.
作者信息
Yan Hongting, Chen Honghai, Liu Yanzhi, Zhang Qiannan, Guo Yunchu, Fu Yu, Ren Hongling, Wang Hairong, Wang Chun, Ge Yusong
机构信息
The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
The Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
出版信息
Front Neurol. 2022 Dec 6;13:1056423. doi: 10.3389/fneur.2022.1056423. eCollection 2022.
OBJECTIVE
This study aimed to investigate early brain microstructural changes discovered using magnetization-prepared two rapid acquisition gradient echo (MP2RAGE) sequence and cerebral hemodynamic using TCD for cognitive impairment after acute cerebral infarction.
METHODS
We enrolled 43 patients with acute cerebral infarction and 21 healthy people in the study, who were subjected to cognitive assessments, the MP2RAGE sequence, and a cerebral hemodynamic examination. A total of 26 brain regions of interest were investigated. Furthermore, we used cerebral hemodynamics to explain brain microstructural changes, which helped us better understand the pathophysiology of cognitive impairment after acute cerebral infarction and guide treatment.
RESULTS
T1 relaxation times in the left frontal lobe, right frontal lobe, right temporal lobe, left precuneus, left thalamus, right hippocampus, right head of caudate nucleus, and splenium of corpus callosum were substantially different across the three groups, which were significantly correlated with neuropsychological test scores. CI group patients had significantly lower cerebral blood flow velocity than those in the N-CI and Normal groups. The receiver operating curve analysis revealed that most T1 relaxation times had high sensitivity and specificity, especially on the right temporal lobe and right frontal lobe. There was a potential correlation between T1 relaxation times and MMSE scores through TCD parameters.
CONCLUSION
The MP2RAGE sequence can detect alterations in whole brain microstructure in patients with cognitive impairment after acute cerebral infarction. Brain microstructural changes could influence cognitive function through cerebral hemodynamics. T1 relaxation times on the right temporal lobe and the right frontal lobe are expected to be a prospective biomarker of cognitive impairment after acute cerebral infarction.
目的
本研究旨在利用磁化准备快速采集梯度回波（MP2RAGE）序列研究急性脑梗死患者认知功能障碍早期脑微结构变化，并采用经颅多普勒（TCD）检测脑血流动力学变化。
方法
本研究纳入43例急性脑梗死患者和21例健康人，对其进行认知评估、MP2RAGE序列检查及脑血流动力学检查。共研究26个脑感兴趣区。此外，我们利用脑血流动力学来解释脑微结构变化，这有助于我们更好地理解急性脑梗死患者认知功能障碍的病理生理学机制并指导治疗。
结果
三组患者左额叶、右额叶、右颞叶、左楔前叶、左丘脑、右海马、右尾状核头部及胼胝体压部的T1弛豫时间存在显著差异，且与神经心理学测试评分显著相关。CI组患者的脑血流速度显著低于N-CI组和正常组。受试者工作特征曲线分析显示，大多数T1弛豫时间具有较高的敏感性和特异性，尤其是在右颞叶和右额叶。通过TCD参数，T1弛豫时间与简易精神状态检查表（MMSE）评分之间存在潜在相关性。
结论
MP2RAGE序列可检测急性脑梗死患者认知功能障碍后的全脑微结构改变。脑微结构变化可通过脑血流动力学影响认知功能。右颞叶和右额叶的T1弛豫时间有望成为急性脑梗死患者认知功能障碍的前瞻性生物标志物。
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