MRI
MRI...2...2 A CORRELATIVITY STUDY OF MRI FINDINGS OF SUBCORTICAL ISCHEMIC VASCULAR DISEASE AND VASCULAR DEMENTIA...3 ABSTRACT...3 MRI...5...5...7...9...13...18...18...23...53...57 1
MRI MRI 28 33 MRI Logistic P<0.05 P<0.05 LA P<0.05 4 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=0.036 2
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
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
MRI stroke-related vascular dementia Alzheimer Alzheimer s disease, AD 1-9 vascular dementia VaD AD 9 1.2%-7.8% 10 VaD AD 20 80 0.4-0.8 0.1-0.4 11-13 VaD AD 20 90 VaD AD 14-16 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
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
VaD VaD MRI VaD VaD VaD VaD SIVaD MRI SIVaD 1 2002 1 2004 2 MRI 1 MRI 2 60 1 2 1.5mm 3 4 5 CO MRI 2 Mini-Mental State Examination MMSE 23 11 30 <17 <20 <22 <23 Activities of Daily Living Scale, ADL 24 20 2 26 82.5% 89.1% 24 NINDS-AIREN 7
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 3 3 28 33 MRI 5 5.1 25 26 MRI A OM 8-9cm B C D BFR 100 E Huchman + F 100 5.2 leukoaraiosis, LA Fukuda 27 MRI LA 5 LA-0 T2 LA-1 T2 LA-2 T2 LA-3 8
LA-4 5.3 6 SPSS10.0 x2 Mann-Whitney t Logistic =0.05 1 MRI 72 4 2 2 3 AD 61 28 33 1.1 21 7 20 13 x 2 =0.240, P=0.233 60 61 94 72.46 ±7.77 61 90 72.00±7.23 t= 0.240, P=0.811 1. 2 4 P>0.05 1 1 9
n=28 n=33 x 2 p n % n % 4 14.3 3 9.1 0.053 0.817 4 14.3 4 12.1 0.000 1.000 13 46.4 19 57.6 0.755 0.385 7 25.0 7 21.2 0.123 0.726 x 2 T>5 x 2 5 T<1 x 2 2 32.1% 82.1% 82.1%, 3 6.1% 57.6% 30.3% P<0.05 P>0.05 2 2 n=28 n=33 x 2 p n % n % 14 50.0 10 30.3 2.463 0.117 4 14.3 1 3.0 1.274 0.259 9 32.1 2 6.1 6.972 0.008 10 35.7 5 15.2 3.454 0.063 24 85.7 29 87.9 0.000 1.000 14 50.0 22 66.7 1.740 0.187 24 85.7 26 78.8 0.492 0.483 10 35.7 9 27.3 0.503 0.478 20 71.4 27 81.8 0.925 0.336 23 82.1 19 57.6 4.263 0.039 15 53.6 15 45.5 0.399 0.527 24 85.7 25 75.8 0.950 0.330 25 89.3 23 69.7 3.466 0.063 23 82.1 10 30.3 16.393 0.000 x 2 T>5 x 2 5 T<1 x 2 3 P<0.05 0.39±0.63 1.39±0.99 1.43±1.00 1.32±0.94, 10
0.06±0.35 0.82±0.46 0.79±0.82 0.36±0.60 P<0.05 P>0.05 3 3 ( ξ±s) Z p n=28 n=33 0.71 ±0.85 0.45 ± 0.75 1.385 0.166 0.14±0.36 0.06±0.35 1.522 0.128 0.39±0.63 0.06±0.35 2.654 0.008 0.46±0.69 0.27±0.80 1.750 0.080 2.50±1.67 2.12±1.24 0.702 0.483 0.93±1.20 1.00±0.94 0.791 0.429 1.39±0.99 0.82±0.46 2.403 0.016 0.43±0.69 0.30±0.53 0.699 0.485 0.96±0.88 1.00±0.61 0.615 0.538 1.43±1.00 0.79±0.82 2.607 0.009 0.64±0.68 0.64±0.86 0.433 0.665 2.46±1.91 1.52±1.25 1.956 0.051 1.29±0.85 0.82±0.64 2.236 0.025 1.32±0.94 0.36±0.60 4.221 0.000 Mann-Whitney 4 LA 61 75.4% LA 89.3% LA 63.6% LA P<0.05 4 LA P<0.05 LA P>0.05 4 LA 4 n=28 LA n=33 x 2 p 11
n % n % 00 3 10.7 12 36.4 5.374 0.020 01 2 7.1 3 9.1 0.000 1.000 02 6 21.4 11 33.3 1.068 0.301 03 6 21.5 6 18.2 0.101 0.751 04 11 39.3 1 3.0 12.600 0.000 x 2 T>5 x 2 5 T<1 x 2 5 Huchman P<0.05 5 5 ( ξ±s, mm) t p n=28 n=33 6.25±1.27 3.25±1.02 10.245 0.000 10.03±2.26 4.18±2.13 10.377 0.000 10.93±2.11 4.82±2.32 10.676 0.000 29.35±2.98 24.92±1.99 7.199* 0.000 31.39±2.60 25.10±1.99 10.687 0.000 50.57±5.62 43.85±2.65 5.807* 0.000 t * t 6 Logistic Backward Stepwise Logistic Logistic 28, P 4 10 3 OR=2.740 OR=1.767 OR=5.807, SIVaD 6 12
6 Logistic B(SE) Wald x 2 P OR (95% CI) 1.008 0.423 5.674 0.017 2.740 1.196 6.280 0.570 0.227 6.284 0.012 1.767 1.132 2.759 1.759 0.839 4.397 0.036 5.807 1.122 3 0.060 1 VaD VaD 29,30 - SIVD 31 32 Brodmann 39 40 37 Luria 1976 perceptive cognitive 39 40 13
33 DSM-IV VaD 20 CT SPECT SPECT VaD 34 SPECT VaD 10 Madureira 35 4 3 12 3 1 3 2 Duus 32 14
1 2 36 -, 2 VaD 37,38 VaD 39 60 68 CT P<0.05 OR=41.6, P=0.005 OR=6.8, P=0.006 VaD - - 40 P<0.05 3 41 15