| Objective: To explore the application value of magnetic resonance three-dimensional arterial spin labeling(3D-ASL)brain perfusion imaging in vascular cognitive impairment.Methods: This study collected 92 patients with ischemic cerebrovascular disease who were hospitalized in the department of neurology of the fourth affiliated hospital of China medical university from August 2018 to January 2020 and improved magnetic resonance 3D-ASL examination.70 patients were selected as subjects strictly according to inclusion and exclusion criteria,and neuropsychological examination(MMSE score and MoCA score)was completed.According to the degree of cognitive impairment of the subjects,they were divided into normal cognitive function group(control group,29 cases),nondementia vascular cognitive impairment group(VCIND,25 cases),and vascular dementia(VD,16 cases).Collect general data of subjects,including age,education level,blood glucose,homocysteine,history of hypertension,history of diabetes,etc.,and record magnetic resonance 3D-ASL cerebral perfusion hemodynamic parameters(CBF)in each group.The risk factors of VCI disease,cerebral blood flow perfusion characteristics in different parts of each group,correlation between MMSE score and MoCA score,and characteristics of each group in related cognitive fields were analyzed.Result: 1.The incidence of vascular cognitive impairment was 58.57%,VCIND was 35.71%,VD was 22.86% in the 70 patients enrolled in this study.The differences between the VCIND group,the VD group,and the control group in the history of hypertension,history of diabetes,and hyperhomocysteinemia were statistically significant(P <0.05).2.The CBF measurements in bilateral frontal lobe,bilateral temporal lobe,bilateral parietal lobe,bilateral thalamus and bilateral radiation crown in VCIND group,VD group and control group were significantly different(p < 0.05);Three groups of subjects were compare between two groups.Comparison between VCIND group and control group,the CBF measurement values in bilateral temporal lobe,bilateral parietal lobe and bilateral radiation crown in VCIND group were lower than those in control group,with statistically significant difference(p < 0.05);Either VD group was compared with control group or VCIND group,the CBF measurements in bilateral frontal lobe,bilateral temporal lobe,bilateral parietal lobe,bilateral thalamus and bilateral radiation crown in VD group were all decreased,with statistically significant difference(P < 0.05);Bilateral frontal lobe,bilateral temporal lobe,bilateral parietal lobe,bilateral occipital lobe,left thalamus and left radiation coronal are positively correlated with MMSE scores(p < 0.05,r = 0.422,0.399,0.363,0.461,0.428,0.508,0.396,0.444,0.648,0.519 respectively);Bilateral frontal lobe,bilateral temporal lobe,bilateral parietal lobe,left occipital lobe and bilateral radiation coronal are positively correlated with MoCA score(p < 0.05,r = 0.422,0.588,0.389,0.442,0.315,0.502,0.510,0.379 and 0.741 respectively);3.MMSE and MoCA were positively correlated.The Spearman correlation coefficient was 0.455,and P = 0.004,which was statistically significant;There were statistically significant differences in language,delayed memory,executive ability,attention and computational power,naming,abstract thinking,orientation and total score comparison among VCIND group,VD group and control group(p < 0.05);Three groups of subjects were compared between two groups.Compared with the control group,the VCIND group had lower scores and total scores in language,delayed memory and executive ability than the control group,and the difference was statistically significant(P < 0.05);Either VD group was compared with control group or VCIND group,The scores and total scores of language,delayed memory,executive ability,attention and calculation ability,naming,abstract thinking and orientation ability in VD group were all decreased,and the difference was statistically significant(p < 0.05).Conclusion: 1.In the composition ratio of vascular cognitive impairment,VCIND patients account for a larger proportion.History of hypertension,diabetes,hyperhomocysteinemia and vascular cognitive impairment have different degrees of correlation.2.Cerebral blood perfusion decreased in different stages of vascular cognitive impairment.In the early stage,there is a significant difference in the decline of bilateral cerebral cortex(temporal and parietal lobe)and bilateral radiation crown.Flow perfusion will decrease further.Head MRI 3D-ASL can provide imaging basis for early identification of vascular cognitive impairment.3.The sensitivity of MMSE combined with MoCA scale to detection of cognitive impairment is improved,which can be used as an effective basis for clinical screening. |
