| As the aging of global population, dementia prevalence rate has increased year by year. Because of the extensive use of MRI, we found that the MRI of elderly head showed there are varying degrees of demyelination in oval centers. Therefore, leukoaraiosis (LA) which was imaging diagnosis terminology first proposed by the Canadian neuroscientist Hachinski in 1987 was paying attention again. Because of LA damage to subcortical functions mainly, namely, advanced neurological function,which often leads to cognitive decline, severe cases can lead to dementia. Therefore, even if normal people had LA, who are also considered an early brain damage signs. Because of there is no effective treatment for LA in the current.That the correct understanding of LA and associated risk factors and early detection of cognitive decline of older persons and to give timely and positive intervention will be beneficial to reduce or block the further deterioration of related diseases. Therefore, the study LA has become a hot spot.In this study,there are 80 cases in LA group and control group (healthy persons) each,These patients came from,China-Japan union hospital of Jilin University outpatient and inpatient department of neurology between 2006 and 2008. These patients were confirmed by MRI T1-weighted lines, MRI T2-weighted imaging examination, and classification in accordance with Hachinski classification standard. MRI shows: T1-weighted images showed equal signal or low signal, T2-weighted images showed high signal; FLAIR sequence imaging is more sensitive to white matter . MRI is divided into four grades according to Hachinski classification standards : 0 grade, that is, the control group: no lesions; 1 grade: lesions confined to the front,center,back around the lateral ventricle ,it can be seen scattered in the limitations of dot-like lesions ; 2 grade: lesions confined to the front,center,back around the white matter of both the lateral ventricle ,it can be seen within the limitations,non-fusion lesions or partial fusion of patchy lesions; 3 grade: lesions integration into sheet, involving white matter around the entire the lateral ventricle. The sex, age and level of education of different grading LA group was no significant difference ,compared with the control group(P> 0.05). To match the two groups of selected personnel to carry out a comparative analysis as the following: The size of the head of quantitative of LA in MRI, MMSE, ADL and neuropsychological tests and risk factors analysis and so on. The results show that, LA group compared with the control group, MMSE score, activities of daily living are lower significantly,that shows LA patients have lower overall cognitive function,and which is positively correlated with the severity of LA.The activities of daily living of classifi- cation1and 2 LA patients has decreased, but there was no significant difference compared with the control group, and activities of daily living in patients with LA 3 classification reduced significantly, there was a significant difference(p<0.05) compared with the control group. Comparing the volume of leukoaraiosis between LA group and control group by Cavalieri principle,the result is positively correlated with the severity of LA. Application of stereological methods to quantitative measurement of LA volume in patients with LA showed that the decline degree of cognitive function and activities of daily living,which is displayed preliminary in this study. There are a lot of risk factors which can cause LA.In this study, we focus on hypertension, hyperlipidemia, smoking, diabetes, coronary heart disease and other major risk factors, conclusions were as follows:⑴LA and hypertension are closely related; the key of treatment is controlling hypertension earlier. LA is closely related with the decline in cognitive function which Includs memory, attention, calculation and visuospatial cognitive functions.⑶Application MRI, in particular MRI T2 can improve the detection rate of LA. The measurement of brain volume of the LA used MRI has some guiding significance to clinical diagnosis and differential diagnosis in patients.⑷MRI is an important means to find age-related leukoarai- osis,which has important significance to prevent Alzheimer's disease. In addition, the Scale for neuropsychological screening should include a more comprehensive examination of cognitive function and user-easily and at the same time with high sensitivity. Relatively speaking, the Cambridge cognitive examination (CAMCOG) is an effective tool which recognized as the more screening for cognitive function now. This scale is more sensitivity and specificity than the MMSE ,avoiding ceiling effects compared with the MMSE. But it focuses on the study of AD and cortical functions, subcortical scale evaluation of cognitive. With the popularity of MRI technology,more and more older people were found to suffering from diseases LA. It mainly damaged subcortical function, So LA is the important determinants of cognitive impairment for patients with multiple cerebral infarction. This study also confirmed this point, the extent of LA was positively correlated with neurological symptoms and signs. The incidence of LA is very complex, cerebral blood flow hypoperfusion and cerebral hypoxia is the important for it. Miyao found that stroke recurrence rate, the rate of dementia, the daily life of dependence was significantly higher than those without LA. Therefore, LA is important with ischemic cerebrovascular disease secondary prevention. Prevention and control of risk factors, the first time to improve the cerebral circulation can reduce the incidence of LA, stroke recurrence rate,improve quality of life. MRI has the advantages than other imaging examination, its high resolution of soft tissue. MRI is the best examination method of LA, it can be used to high-risk groups if economic conditions permit.
|
PDF Full Text Request