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目的观察认知训练前后遗忘型轻度认知障碍(a MCI)患者海马亚区磁共振成像(MRI)T_2信号的变化,为a MCI的临床早期诊疗提供影像学帮助。方法 2014年10月至2015年8月,a MCI患者40例随机均分为认知训练组和沟通组,另选老年健康志愿者20例作为对照组。认知训练组接受认知训练,沟通组采用普通谈话沟通,共治疗3个月。治疗前后采用快速自旋回波T_2序列进行MRI检查,于工作站中勾画海马各亚区,测量T_2信号强度,对T_2信号强度与简易精神状态检查(MMSE)评分进行相关性分析。结果治疗前,与对照组比较,认知训练组和沟通组双侧海马头部T_2信号强度增高(P<0.05),认知训练组与沟通组之间无显著性差异(P>0.05)。治疗后,认知训练组左侧海马头部T_2信号强度下降,与对照组无显著性差异(P>0.05),低于沟通组(P<0.05);认知训练组MMSE评分较治疗前升高(t=3.07,P<0.05)。治疗前后,认知训练组MMSE评分与左侧海马头部T_2信号强度均呈负相关(r=-0.61,r=-0.54,P<0.05)。双侧体、尾部T_2信号强度治疗前后各组间均无显著性差异(t<0.62,P>0.05)。结论左侧海马头部MRI T_2信号强度可反映aMCI颅内的病理生理改变,可用于评估认知训练效果,也可作为aMCI早期诊疗的辅助指标。
Objective To observe the change of magnetic resonance imaging (MRI) T_2 signal in the hippocampal subfields of patients with amnestic mild cognitive impairment (aMCI) before and after cognitive training, and to provide imaging help for the early clinical diagnosis and treatment of a MCI. Methods From October 2014 to August 2015, 40 patients with a MCI were randomly divided into cognitive training group and communication group, and 20 healthy volunteers were selected as control group. Cognitive training group received cognitive training, communication group using ordinary conversation, a total of 3 months of treatment. Before and after treatment, the T 2 sequence of rapid spin echo was used for MRI examination. The hippocampal subregion was delineated in the workstation. The signal intensity of T 2 was measured and the correlation between T 2 signal intensity and MMSE score was analyzed. Results Before treatment, compared with the control group, the signal intensity of T 2 in hippocampus of cognitive training group and communicating group increased (P <0.05), and there was no significant difference between cognitive training group and communicating group (P> 0.05). After treatment, the signal intensity of T 2 in the left hippocampus of the cognitive training group was lower than that in the control group (P 0.05), but lower than that in the communication group (P 0. 05). The MMSE score of cognitive training group was significantly lower than that of the control group High (t = 3.07, P <0.05). Before and after treatment, MMSE score in cognitive training group was negatively correlated with T 2 signal intensity in the left hippocampus (r = -0.61, r = -0.54, P <0.05). Bilateral and tail T 2 signal intensity before and after treatment were not significantly different between groups (t <0.62, P> 0.05). Conclusion MRI T 2 signal intensity in the head of the left hippocampus can reflect the pathophysiological changes of aMCI intracranial. It can be used to evaluate the effect of cognitive training. It can also be used as an auxiliary index for the early diagnosis and treatment of aMCI.