MRI A CORRELATIVITY STUDY OF MRI FINDINGS OF SUBCORTICAL ISCHEMIC VASCULAR DISEASE AND VASCULAR DEMENTIA...3 ABSTRACT...3 MRI

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2 MRI A CORRELATIVITY STUDY OF MRI FINDINGS OF SUBCORTICAL ISCHEMIC VASCULAR DISEASE AND VASCULAR DEMENTIA...3 ABSTRACT...3 MRI

3 MRI MRI MRI Logistic P<0.05 P<0.05 LA P< LA P<0.05 Huchman P<0.05 Logistic OR=2.740, P=0.017 OR=1.767, P=0.012 OR=5.807, P=

4 A correlativity study of MRI findings of subcortical ischemic vascular disease and vascular dementia Abstract Objective To explore the correlation of MRI of subcortical ischemic vascular disease and vascular dementia. Methods The MRI features were analysed and compared between 28 cases of dementia and 33 cases of nondementia with subcortical multi-infarct. Logistic regression analyses were used to identify MRI risk factors of subcortical ischemic vascular dementia. Results The frequency of parietal subcortical, genu internal capusle and thalamus infarcts were more frequent in dementia group than in control group P<0.05. The number of parietal subcortical, anterior white matter around the body of lateral ventricle, genu internal capusle, and thalamus infarcts were more in dementia group than in control group 3

5 P<0.05. Leukoaraiosis of 4 degree was more common in dementia group than in control group P<0.05.The mean width of the cerebral sulci and sylvian fissure,the width of third ventricle, the frontal horn index,the lateral ventricle index and Huchman index in dementia group were larger than in control group significantly P<0.05.Logistic regression showed that the mean width of the cerebral sulci OR=2.740, P=0.017, the lateral ventricle index (OR=1.767, P=0.012 and the number of thalamus infarcts(or=5.807,p=0.036 were significantly correlated with vascular dementia. Conclusion Subcortical ischemic vascular dementia may be correlated with the degree of brain atrophy and the number of thalamus infarcts. Key Words: subcortical ischemic vascular disease; vascular dementia; magnetic resonance imaging 4

6 MRI stroke-related vascular dementia Alzheimer Alzheimer s disease, AD 1-9 vascular dementia VaD AD 9 1.2%-7.8% 10 VaD AD VaD AD VaD AD VaD VaD AD VaD VaD MRI MRI VaD VaD VaD VaD VaD VaD MRI VaD 2000 Pohjasvaara 17 VaD (DSM-III, ADDTC, ICD-10, NINDS-AIREN, DSM-IV) VaD VaD 5

7 VaD subcortical ischemic vascular disease and dementia SIVD and SIVaD SIVD small vessel disease SIVD Binswanger 18,19 SIVD MRI SIVD MRI 1 2 white matter signal hyperintensities WMSHs WMSHs MRI VaD 20 SIVD VaD AD SIVD VaD Fein 21 SIVD white matter changes, WMC Mungas 22 MRI white matter lesions, WML SIVD SIVaD AD SIVD VaD MRI VaD VaD 6

8 VaD VaD MRI VaD VaD VaD VaD SIVaD MRI SIVaD MRI 1 MRI mm CO MRI 2 Mini-Mental State Examination MMSE <17 <20 <22 <23 Activities of Daily Living Scale, ADL % 89.1% 24 NINDS-AIREN 7

9 VaD 20 MMSE ADL 3 1.5T Signa CVi GE 5mm SE T1WI(TR 2017ms TE 9.6ms) FSE T2WI(TR 4700ms TE 106ms) 4 MMSE ADL MRI MRI A OM 8-9cm B C D BFR 100 E Huchman + F leukoaraiosis, LA Fukuda 27 MRI LA 5 LA-0 T2 LA-1 T2 LA-2 T2 LA-3 8

10 LA SPSS10.0 x2 Mann-Whitney t Logistic = MRI AD x 2 =0.240, P= ± ±7.23 t= 0.240, P= P>

11 n=28 n=33 x 2 p n % n % x 2 T>5 x 2 5 T<1 x % 82.1% 82.1%, 3 6.1% 57.6% 30.3% P<0.05 P> n=28 n=33 x 2 p n % n % x 2 T>5 x 2 5 T<1 x 2 3 P< ± ± ± ±0.94, 10

12 0.06± ± ± ±0.60 P<0.05 P> ( ξ±s) Z p n=28 n= ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± Mann-Whitney 4 LA % LA 89.3% LA 63.6% LA P< LA P<0.05 LA P> LA 4 n=28 LA n=33 x 2 p 11

13 n % n % x 2 T>5 x 2 5 T<1 x 2 5 Huchman P< ( ξ±s, mm) t p n=28 n= ± ± ± ± ± ± ± ± * ± ± ± ± * t * t 6 Logistic Backward Stepwise Logistic Logistic 28, P OR=2.740 OR=1.767 OR=5.807, SIVaD 6 12

14 6 Logistic B(SE) Wald x 2 P OR (95% CI) VaD VaD 29,30 - SIVD Brodmann Luria 1976 perceptive cognitive

15 33 DSM-IV VaD 20 CT SPECT SPECT VaD 34 SPECT VaD 10 Madureira Duus 32 14

16 , 2 VaD 37,38 VaD CT P<0.05 OR=41.6, P=0.005 OR=6.8, P=0.006 VaD P<

by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (2

by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (2 论著临床研究 doi: 0.7499/j.issn.008-8830.204.2.007 郑州市城区儿童哮喘的流行病学调查及发病相关因素分析赵坤宋桂华古华倩 2 刘爽 3 张岩郭彦荣 (. 河南中医学院第一附属医院儿科医院, 河南郑州 450000; 2. 杭州市余杭区