磁共振成像2025，Vol.16Issue(10)：28-34,7.DOI:10.12015/issn.1674-8034.2025.10.005
QSM联合DKI评估脑小血管病伴轻度认知障碍脑灰质核团铁沉积和微结构
QSM and DKI for evaluation of iron deposition and microstructural alterations in gray matter nuclei of cerebral small vessel disease with mild cognitive impairment
摘要
Abstract
Objective:To investigate iron deposition and microstructural damage in gray matter nuclei of patients with cerebral small vessel disease with mild cognitive impairment(CSVD-MCI)using quantitative susceptibility mapping(QSM)and diffusional kurtosis imaging(DKI),and to explore their correlations with cognitive function.Materials and Methods:The imaging and clinical data of 5 CSVD-MCI patients diagnosed in Guizhou Provincial People's Hospital from December 2022 to March 2024 were retrospectively collected.A total of 28 CSVD-MCI patients with comprehensive clinical diagnosis in Guizhou Provincial People's Hospital from March 2024 to December 2024 were prospectively enrolled.Finally,33 CSVD-MCI patients were enrolled.Thirty-two normal controls matched for age,sex and years of education were recruited,and the Montreal Cognitive Assessment(MoCA)scores of the two groups were collected.All participants underwent 3D-T1WI,QSM and DKI sequence scanning on a GE 3.0 T superconducting MRI scanner.Using the uAI Discovery-brain platform and a brain atlas,the whole brain was segmented into 51 subregions.Bilateral gray matter nuclei,including the caudate nucleus,putamen,globus pallidus,and thalamus,were selected for analysis.Susceptibility values,kurtosis fractional anisotropy(KFA),mean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)were extracted for each nucleus using coarse-grained quantitative analysis based on segmentation.Between-group differences in susceptibility and DKI parameters were assessed using independent samples t-tests for normally distributed data and Mann-Whitney U tests for non-normally distributed data.Spearman correlation analysis was used to examine relationships between imaging parameters and MoCA scores.A significance threshold of P<0.05 was applied.Results:(1)No significant differences were observed between groups in age,sex,or education level(all P>0.05),while MoCA scores differed significantly(P<0.05).(2)Compared to HCs,the CSVD-MCI group exhibited significantly increased susceptibility in the bilateral globus pallidus(both P<0.05).Significantly decreased KFA was observed in the bilateral caudate nucleus,putamen,and thalamus(all P<0.05).MK showed no significant differences(P>0.05).Significantly decreased AK was found in the bilateral caudate nucleus,right putamen,and bilateral thalamus(all P<0.05).Significantly increased RK was observed in the bilateral putamen(both P<0.05).(3)In the CSVD-MCI group,susceptibility in the bilateral putamen(left:r=-0.294,P=0.017;right:r=-0.328,P=0.008)correlated negatively with MoCA scores.KFA(r=0.417,P=0.016),MK(r=0.401,P=0.020),AK(r=0.395,P=0.023),and RK(r=0.351,P=0.045)in the left globus pallidus correlated positively with MoCA scores.Susceptibility in the bilateral putamen(left:r=-0.356,P=0.041;right:r=-0.449,P=0.008)correlated negatively with KFA values.Conclusions:There are abnormal iron metabolism and microstructural damage in the gray matter nucleus in CSVD-MCI patients.The cognitive ability of CSVD-MCI patients is related to the iron content in bilateral putamen and the microstructural integrity of left globus pallidus.QSM and DKI provide a new perspective for early diagnosis,early intervention and personalized treatment of cerebral small vessel disease.关键词
脑小血管病/认知障碍/磁共振成像/定量磁化率成像/扩散峰度成像Key words
cerebral small vessel disease/cognitive impairment/magnetic resonance imaging/quantitative susceptibility mapping/diffusional kurtosis imaging分类
医药卫生引用本文复制引用
李洪进,王渤,幸志洋,王荣品,张体江..QSM联合DKI评估脑小血管病伴轻度认知障碍脑灰质核团铁沉积和微结构[J].磁共振成像,2025,16(10):28-34,7.基金项目
Construction of Scientific and Technological Innovation Talent Team of Functional Imaging and Artificial Intelligence Application Research in Guizhou Province(No.QianKeHeRenCai CXTD[2025]047) （No.QianKeHeRenCai CXTD[2025]047）
Hundred-Level Talent Project of Guizhou Province,China(No.Qiankehe Platform Talent-GCC[2022]041-1). 贵州省功能影像与人工智能应用研究科技创新人才团队建设项目(编号:黔科合人才CXTD[2025]047) （No.Qiankehe Platform Talent-GCC[2022]041-1）
贵州省百层次人才项目(编号:黔科合平台人才-GCC[2022]041-1) （编号:黔科合平台人才-GCC[2022]041-1）
