MRI Analysis Of 80 Patients With Vascular Dementia

ObjectiveHead MRI images from 80 patients with vascular dementia(VaD), 80 stroke without dementia(SWD) patients and 80 healthy elderlys(HE) were measured, compared and analyzed, in order to explore the MRI characteristics of VaD. In addition, patients in VaD groups performed susceptibility weighted imaging(SWI) scan, which was used to explore the correlation in cognitive disorder caused by cerebral microbleeds(CMBs) andVaD. Method90 patients(1 constructed defect;9 lost to follow-up; 80 entering into the group finally and effectively) with VaD were enrolled as the VaD group,who were clinically diagnosed of acute cerebral infarction within 4 weeks in the Department of Neurology, the First Affiliated Hospital of Zhengzhou University, from January 2014 to December 2015; on the same period, 80 patients with SWD and 80 HE were selected as the SWD and HE groups, respectively. The age, sex and educational status were matched among the three groups. All the subjects were tested by neuropsychological test, and VaD diagnoses were made as defined via Diagnostic and Statistical Manual of Mental Disorder-IV(DSM-IV). A MRI scanner(Siemens Verio3.0T) was employed for head MRI scanning. Measured indicators included as follows: brain ventricle indexes, body of lateral brain ventricle width indexes, anterior horn indexes, the width of three brain ventricles, lateral fissure width indexes, anterior diastematia width indexes, choroid fissure width indexes, the degree of white matterlesions(WMLs), and the volume and position of cerebral infarction. Patients in the VaD group were divided into the CMBs group and the no CMBs group, in accordance with the sequence scanning results of SWI. Result1. Body of lateral brain ventricle width indexes, anterior horn indexes and both lateral fissure width indexes of patients in the VaD group were less than those in the SWD and HE groups(p=0.000); the width of three brain ventricles of patients in the VaD group was larger than that in the SWD and HE groups(p=0.000); and anterior diastematia width indexes and both choroid fissure width indexes of patients in the VaD group were less than those in the HE group(p=0.000).2. Body of lateral brain ventricle width indexes, anterior horn indexes, both lateral fissure width indexes, anterior diastematia width indexes, and both choroid fissure width indexes of patients in the SWD group were less compared with those in the HE group(p=0.000); the width of three brain ventricles of patients in the SWD group was larger compared with that in the HE group(p=0.000).3. No statistical differences were observed in the incidence of WMLs between the VaD group and the SWD group(P = 0.838); moderate and severe incidences of WMLs were higher in the VaD group in comparison of those in the SWD group(all P< 0.05).4. The total of left cortex infarction volume of cerebral infarction, left total cortex infarction volume, left parietal lobe cortex infarction volume, left temporal lobe cortex infarction volume and the left cerebral infarction volume of patients were larger in the VaD group as compared with those in the SWD group(all P<0.005).5. The results of logistic regression model indicated that systolic blood pressure and National Institutes of Health Stroke Scale(NIHSS) score were predictors for CMBs in patients with acute cerebral infarction(P=0.009 and P=0.014, respectively)6. The total score of MoCA scale was significantly lower in the CMBs group as compared with that in the no CMBs group. Significant differences were noticed in the executive function, visual spatial function score and calculated score between both groups(all P<0.005). And there was no significant difference in memory, attention, orientation and language function(all P> 0.05).7. During the follow-up of patients in the VaD group, scores of cognitive function of patients in the CMBs group and no CMBs group showed a gradually decreased trend; the total score of MoCA scale in all periods were significantly lower in the CMBs group as compared with those in the no CMBs group(all P< 0.05). Conclusion1. Whether or not WMLs are independent of VaD, moderate or severe WMLs are more likely to result in VaD.2. Compared with healthy peers, stroke brain atrophy obvious, but more pronounced brain atrophy in patients with VaD.3. The left side of the cortical infarct volume, especially in the left parietal lobe, the left temporal cortex infarct volume and the total volume of bilateral thalamus infarction associated with VaD.4. CMBs closely associated with VaD, the more serious CMBs, Va D more obvious symptoms, and cognitive function in patients with CMBs damage over time and aggravation.