| Objective: The aim of this study is to investigate the changed characteristics of cognitive impairment and cerebral blood flow(CBF)in patients with cerebral small vessel disease(CSVD),to determine the correlation between cognitive impairment with risk factors and CBF in CSVD,and to clarify the clinical value of three-dimensional arterial spin labeling technique(3D-ASL)in CSVD.Methods: Sixty-three patients with cerebral small vessel disease were included to the CSVD group,and further divided into the CSVB cognitive impairment group and the CSVB without cognitive impairment group according to the results of MMSE and Mo CA.Meanwhile,thirty healthy controls matched on sex,age and educational level were included.The basic clinical data,blood pressure and biochemical indexes of all enrolled members were collected.Conventional sequence and 3D-ASL sequence scanning of 3T MRI was conducted,and the regional cerebral blood flow(CBF)of the brain region of interest was measured.We compared the differences of total MMSE scores,Mo CA scores and item scores between groups;the differences of age,blood pressure and biochemical indexes between groups;the differences of CBF values of different parts between groups;andanalyzed the correlation between CBF values with Mo CA item scores and risk factors in CSVB cognitive impairment group.Results: 1.The total score of MMSE,Mo CA and the scores of visual space and executive ability,attention and memory in CSVD cognitive impairment group were lower than those in non-cognitive impairment group and control group(all P < 0.05).2.The levels of SBP,DBP,Hb A1 c,LDL and HS-CRP in CSVD group were significantly higher than those in control group.The age,SBP and HS-CRP levels in the CSVD cognitive impairment group were higher than those in the non-cognitive impairment group.3.The CBF values of left superior frontal gyrus,right superior parietal lobule,left centrum semiovale and bilateral white matter central part of lateral ventricle in CSVD group were lower than those in control group(all P < 0.05).In CSVD group,the CBF values of bilateral superior frontal gyrus,right superior temporal gyrus,left centrum semiovale and bilateral white matter central part of lateral ventricle in patients with cognitive impairment were lower than those without cognitive impairment,while CBF values in right thalamus and left hippocampus were higher than those without cognitive impairment.4.The correlation between CBF and cognitive function in the CSVD cognitive impairment group indicate that the CBF of left superior frontal gyrus and right white matter central part of lateral ventricle was positively correlated with visual spatial executive function,the CBF of right superior parietal lobule and right occipital pole was positively correlated with memory,and the CBF of right thalamus and left hippocampus was negatively correlated with attention(all P <0.05).5.The correlation between CBF value and risk factors in the CSVD cognitive impairment group showed that the CBF value of left superior frontal gyrus and bilateral white matter central part of lateral ventricle was negatively correlated with age,the CBF value of right superior temporal gyrus and right globus pallidus was negatively correlated with SBP,the CBF value of right globus pallidus was negatively correlated with DBP,the CBF value of right head of caudate nucleus was negatively correlated with Hb A1 c,the CBF value of right superior temporal gyrus and right cerebellar hemisphere was negatively correlated with LDL,and the CBF value of white matter near the center of left thalamus and right white matter central part of lateral ventricle was negatively correlated with HS-CRP.Conclusion: 1.Patients with CSVD have cognitive impairment,mainly in visuospatial executive ability,attention and memory.2.The levels of blood pressure,blood glucose,blood lipid and hypersensitive C-reactive protein in patients with CSVD were significantly increased.In addition,the age,systolic blood pressure and the level of hypersensitive C-reactive protein in patients with cognitive impairment were significantly higher than those without cognitive impairment.3.There are multiple sites of changes of CBF in patients with CSVD.The decrease and increase of CBF exist at the same time,and most of them decrease,while a small part increased.The CBF in multiple sites of patients with cognitive impairment was significantly lower than that of those without cognitive impairment,with the exception of that in right thalamus and left hippocampus,which might be related to the compensatory increase of regional CBF.4.The value of CBF was correlated with visuospatial executive ability,attention and memory,suggesting that the occurrence of cognitive dysfunction may be related to the changes of cerebral blood flow.5.The value of CBF was negatively correlated with age,blood pressure,blood glucose,blood lipids and high sensitivity C-reactive protein,suggesting that with the increase of age,blood pressure,blood glucose,blood lipids and high sensitivity C-reactive protein,the value of CBF might gradually decreased.6.As a non-invasive examination method,3D-ASL can accurately and intuitively reflect the regional cerebral blood flow of CSVD patients,so as to provide a new safe and reliable examination method for clinical evaluation. |
