三维动脉自旋标记成像相关参数对缺血性脑白质疏松患者认知功能障碍的诊断价值

doi:10.3969/j.issn.1671-7171.2026.07.025

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摘要 【目的】探讨三维动脉自旋标记(3D-ASL)成像相关参数对缺血性脑白质疏松(ILA)患者认知功能障碍的诊断价值。【方法】依据蒙特利尔认知评估量表(MoCA)评分,将85例ILA患者分为认知功能障碍组(A组,30例)和认知功能正常组(B组,55例),采用3D-ASL成像相关参数获取患者的全脑感兴趣区域(ROI)的脑血流量(CBF)。采用多因素Logistic回归分析筛选影响ILA患者发生认知功能障碍的相关因素,采用受试者操作特征(ROC)曲线分析各指标对ILA患者发生认知功能障碍的诊断效能。【结果】A组患者年龄、ILA 3级占比及同型半胱氨酸(Hcy)、纤维蛋白原(FIB)水平均高于B组(P<0.05),C反应蛋白(CRP),全脑、脑室旁及皮质下区的CBF值均低于B组(均P<0.05);Logistic回归分析显示,年龄、ILA分级、Hcy、FIB是ILA患者认知功能障碍的危险因素(P<0.05),CRP,全脑、脑室旁、皮质下区的CBF是保护因素(P<0.05);ROC曲线分析显示,全脑、脑室旁、皮质下区的CBF三者联合诊断ILA患者认知功能障碍的曲线下面积(AUC)为0.959,诊断效能显著优于各指标单独检测。【结论】年龄、ILA分级、Hcy、FIB、CRP及CBF值是影响ILA患者认知功能的重要因素,全脑、脑室旁及皮质下区CBF值对ILA患者认知功能障碍具有较高的诊断价值。

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	仝向莎
	詹浩辉
	胡舸帆

关键词 ：脑白质疏松症, 认知功能障碍, 磁共振成像

Abstract：【Objective】 To investigate the diagnostic value of three-dimensional arterial spin labeling (3D-ASL) for cognitive dysfunction in patients with ischemic leukoaraiosis (ILA). 【Methods】 According to the Montreal Cognitive Assessment (MoCA) scores, 85 patients with ILA were divided into a cognitive dysfunction group (Group A, n=30) and a normal cognitive function group (Group B, n=55).3D-ASL was performed to obtain cerebral blood flow (CBF) values in whole-brain regions of interest (ROIs). Multivariate logistic regression analysis was used to identify factors associated with cognitive dysfunction in patients with ILA. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance for cognitive dysfunction in ILA patients. 【Results】 Compared with Group B, Group A had significantly higher age, proportion of grade 3 ILA, homocysteine (Hcy), and fibrinogen (FIB) levels, while C-reactive protein (CRP) levels and CBF values in the whole brain, periventricular region, and subcortical region were significantly lower (all P<0.05). Multivariate logistic regression analysis showed that age, ILA grade, Hcy, and FIB were risk factors for cognitive dysfunction in patients with ILA (P<0.05), whereas CRP and CBF values in the whole brain, periventricular region, and subcortical region were protective factors (P<0.05). ROC curve analysis demonstrated that the combined detection of whole-brain, periventricular, and subcortical CBF values yielded an area under the curve (AUC) of 0.959, with significantly better diagnostic performance than any single indicator alone. 【Conclusion】 Age, ILA grade, Hcy, FIB, CRP, and CBF levels are important factors affecting cognitive function in patients with ILA. The combined assessment of CBF values in the whole brain, periventricular region, and subcortical region provides higher diagnostic value for cognitive dysfunction in patients with ILA.

Key words： Leukoaraiosis Cognitive Dysfunction Magnetic Resonance Imaging

收稿日期: 2026-01-14

中图分类号:

R742.89

引用本文:

仝向莎, 詹浩辉, 胡舸帆. 三维动脉自旋标记成像相关参数对缺血性脑白质疏松患者认知功能障碍的诊断价值[J]. 医学临床研究, 2026, 43(7): 1144-1147.
TONG Xiangsha, ZHAN Haohui, HU Gefan. Diagnostic Value of Related Parameters of Three-Dimensional Arterial Spin Labeling Imaging for Cognitive Dysfunction in Patients with Ischemic Leukoaraiosis. JOURNAL OF CLINICAL RESEARCH, 2026, 43(7): 1144-1147.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.07.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I7/1144

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