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Correlation between DTI, TCM Symptoms and Vascular Cognitive Impairment with Leukoaraiosis

Author: PangRan
Tutor: ZhaoJing
School: Beijing University of Traditional Chinese Medicine
Course: Traditional Chinese Medicine
Keywords: Diffusion tensor imaging The vasogenic mild cognitive impairment Vascular Dementia Syndrome elements
CLC: R277.7
Type: Master's thesis
Year: 2011
Downloads: 60
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Abstract


Objective: To study and compare vasogenic mild cognitive impairment (vMCI), vascular dementia (VD) and normal elderly (NC) MRI leukoaraiosis (LA), diffusion tensor imaging (DTI) observe the different parts of the white matter fiber tracts FA (fractional anisotropy) value and ADC (apparent diffusion coefficient) values ??change, and to explore the the vasogenic cognitive impairment (VCI) changes in the characteristics of the white matter fiber tracts in patients, evaluation of DTI diagnosis value. Analysis of VCI patients with TCM syndrome factors of distribution and its relationship with the DTI parameters to the the objective visualization based on traditional Chinese medicine syndrome VCI molecular level. MATERIALS AND METHODS: vascular etiology, 98 underwent DTI scanning routine head MRI (Equipment used for the the Philips 1.5T superconducting MRI instrument) and neuropsychological assessment, based on the above assessment is divided into NC (35 Li) , vMCI (50 cases) and VD (13 patients) three groups, by more than 2 Fu Gaozhi Physician its TCM syndrome factors were assessed. First observation groups T2WI-FLAIR sequence subcortical and periventricular (corona radiata or centrum ovale) and basal nuclei (internal capsule or thalamus) leukoaraiosis high signal nonparametric test was used to compare the three FA values ??and ADC values ??of the differences between groups the LA lesion classification (Aharon Peretz Act) and lesions range; then, were measured in the post-processing workstation on the the bilaterians site region of interest (ROI): sniffing the inside back to the white matter, the hippocampus cingulate front and rear, next time frontal white matter, temporal lobe white matter on the back of the white matter and occipital angular gyrus. Using analysis of variance and LSD test distribution among the three groups on various parts of the left and right sides of the ROI FA values ??and ADC values ??pairwise comparisons between the comparison and the group. Finally, a comparison with the results of the factor analysis of distribution statistics the vMCI group and VD group syndrome elements and their FA values. Results: 1 LA lesion classification: NC group 0 and a majority (31 cases, 91.18%), the majority (39 cases, 78.0%) vMCI groups 2 and 3, the VD group mostly 3 and 4 ( 12 cases, 92.31%), was the the the heavier cognitive impairment LA higher grade trend. LA lesions ranges: NC group front to the lateral ventricle majority (seven cases, 41.2%), vMCI groups mostly in the frontal and parietal white matter (33 cases, 71.74%), the VD group mostly involved the whole white matter regions (9 cases, 69.23%). 3, (1) FA values: the left and right sides of each group comparison shows the inside of the right side of the olfactory back, the left cingulate rear and both sides of the inferior frontal gyrus white matter fibers there is a statistically significant difference (p lt; 0.05). Pairwise comparisons show the NC group vMCI group sniffing in the right side of the inside of the back and both sides of the inferior frontal gyrus white matter (FA value) there is a significant difference (p lt; 0.01) between the NC group and VD group on the right olfactory within side of the back, the right hippocampus, both sides of the buckle back to the rear, on both sides of the inferior frontal gyrus and left occipital lobe white matter between the angular gyrus was statistically significant (p lt; 0.05) to both sides of the inferior frontal gyrus FA value differences most significantly, vMCI VD group only back to the white matter FA values ??in the left corner with a significant difference. (2) ADC values: the right and left sides in each group comparison shows that both sides of the olfactory medial back, left hippocampus, both sides of the buckle back to the front, both sides of the inferior frontal gyrus, both sides of the superior temporal gyrus and both sides of the occipital white quality there is a statistically significant difference (p lt; 0.05), between the fiber bundles lesion ADC value of the lack of specificity. FA and certificate candidates relationship: the 50 cases vMCI and 13 cases of VD syndrome elements distribution yang, yin the highest frequency of occurrence of each to 41.27% and 38.10%, stasis, fire, phlegm ranking followed, each 20.63 %, 17.46% and 15.87%, less qi and blood deficiency, are 12%, Wind Syndrome least 1.5%. Syndrome factor group and the inferior frontal gyrus white matter FA values ??between no statistically significant difference (p gt; 0.05). Conclusion: 1, the vasogenic cognitive impairment LA severity and extent of disease has a correlation with the the LA lesion area increases and an increase in the extent of disease and gradually worsened, the lesion was from front to back gradual development trend. Both sides of the amount of the NC group with vMCI of the next time the white matter FA values ??there is a significant difference, suggesting that DTI can be used as a method for early diagnosis of vascular cognitive impairment. NC group and VD group inside the right side of the olfactory back right hippocampus, both sides of the posterior cingulate cortex, bilateral inferior frontal gyrus and left occipital lobe angular gyrus significant difference between the white matter FA values, vMCI with The VD group left angular gyrus white matter FA values ??have significant differences, also shows that the lesion is a progressive development from front to back. Relationship between the VCI certificate the pheromone distribution and MRI in the FA represent white matter lesions anisotropy without significant correlation, this needs to continue further study.

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