Application Of Magnetic Resonance Three-dimensional Arterial Spin Labeling Imaging In The Changes Of Cerebral Blood Flow And Cognitive Function Of Patients With Moderate-severe Osahs

Objective:To evaluate the changes of cerebral blood flow perfusion in patients with moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS)using three-dimensional arterial spin labeling(3D-ASL).and the relationship between the changes of cerebral blood perfusion and the severity of OSAHS and cognitive function was further analyzed.Methods:26 newly diagnosed patients with moderate to severe OSAHS by polysomnography and 26 age and gender and educational level-matched normal controls from the Sixth Hospital of Shanxi Medical University were collected.MRI data acquisition was performed with GE SIGNA Pioneer 3 T esla to completed routine MRI、3D-T1 and3D-ASL scanning,the cerebral blood flow(CBF)was measured in gray and white matter areas.Mini-mental State Examination and Montreal cognitive assessment scale were used to evaluate cognitive function in patients and controls.The independent sample t test and Wilcoxon rank sum test were used to analyze the genaral data,CBF values of each brain region and the cognitive scores of the two groups,and the bivariate correlation analysis was conducted between the CBF values of brain regions with differences and the AHI,scores of MOCA and MMSE cognitive scales.Results:Compared with healthy control group,local CBF of bilateral parietal white matter,left hippocampus,right caudate nucleus head and left putamen in moderate and severe OSAHS patients decreased,with statistical significance(all P values<0.05).The scores of language,visuospatial and executive,attention,delayed memory,and MMSE and MOCA in moderate and severe OSAHS patients were significantly lower than those in healthy control group,with statistical significance(all P<0.05).Correlation analysis showed that the CBF value of of the right caudate nucleus head(r_s=0.554,0.419,P values<0.05),the left putamen(r_s=0.52,0.405,P values<0.05),and the left hippocampus(r_s=0.679,0.396,P values<0.05)was positively correlated with MOCA and MMSE scores,The CBF value of Left hippocampus was positively correlated with delayed memory score(r_s=0.576,P=0.002).The CBF value of bilateral parietal white matter(r_s=-0.538,-0.590,P<0.05),right caudate nucleus head(r=-0.491,P<0.05),the left putamen(r=-0.491,P<0.05)was negatively correlated with AHI.Conclusion:3D-ASL can sensitively detect the changes of cerebral blood flow in patients with OSAHS,and the cerebral blood flow decreases with the increase of the severity of the disease,and there was a positive correlation between low perfusion brain area and cognitive function,which provides an objective imaging basis for explaining the occurrence of cognitive dysfunction in patients with OSAHS.