MR difūzijas (tensora) izmeklējuma kvantitatīvo raksturlielumu saistība ar kognitīvo testu rezultātiem
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Date
2023
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Difūzijas tensora attēlveidošana (DTI) ir magnētiskās rezonanses metode, kas sniedz datus par smadzeņu baltās vielas savienojumiem un mikrostrukturālo organizāciju. DTI metodes pamatprincipi balstās uz ūdens molekulu virzību pa nervu aksoniem, kas var tikt atspoguļota gan ar kvalitatīviem , gan ar kvantitatīviem datiem. Ar DTI iegūtie kvantitatīvie dati jeb skalāri ( frakcionētā anizotropija (FA), vidējā difuzivitāte (MD), aksiālā difuzivitāte (AD) un radiālā difuzivitāte) var tikt izmantoti, lai izvērtētu pacienta kognitīvo traucējumu smagumu. Šī pētījuma mērķis bija noskaidrot vai pastāv saistība starp DTI kvantitatīvajiem raksturlielumiem un kognitīvo veiktspēju. Pētījumā tika iekļauti 25 pacienti ar variablām kognitīvajām spējām. Pirms attēldiagnostikas neirologs izvērtēja pacientus ar Monreālas kognitīvā novērtējuma (MoCA) testu. Izrietoši no iegūtā vērtējuma pacienti tika sadalīti trīs apakšgrupās (normālas kognitīvās spējas (NC), viegli/vidēji smagi kognitīvie traucējumi (MCI) un smagi kognitīvie traucējumi (SCI) ). Attēldiagnostika tika veikta ar 3.0 T jaudīgām MR iekārtām. Difūzijas attēli tika apstrādāti ar DSI studio programmatūru, no kuriem tika iegūta kvantitatīva informācija, par sekojošiem reģioniem: whole brain, forceps minor, corpus callosum, forceps major un fornix. Iegūtie dati tālāk tika sagrupēti un izanalizēta ar JASP matemātiskās statistikas programmatūru.
Statistiski nozīmīgas atšķirības tika atrastas izvērtētjo whole brain jeb kopējā smadzeņu reģiona AD, šī vērtība bija palielināta SCI grupai salīdzinājumā ar NC (p<0,05), kā arī tā bija palielināta salīdzinot SCI grupu ar MCI (p<0,05). Izvērtējot corpus callosum ķermeni statistiski nozīmīgas atšķirības tika atrastas MD, šī vērtība bija palielināta SCI grupai salīdzinājumā ar NC (p=0,003) , kā arī tā bija palielināta salīdzinot SCI grupu ar MCI (p=0,011). Pārējos apskatītajos smadzeņu reģionos arī tika konstatētas izmaiņas kvantitatīvajās vērtībās tomēr tās nebija statistiski nozīmīgas. Pēc šajā pētījumā iegūtajiem datiem var spriest, ka DTI kvantitatīvajām raksturvērtībām var būt saistība ar pacientu kognitīvo veiktspēju. Iegūtie dati līdzinās esošiem pētījumiem par difūzijas metodes pielietošanu pie dažādu neiroloģisku slimību, tai skaitā demenču diagnostikas. Nākotnē DTI kvantitatīvajiem raksturlielumiem ir potenciāls tikt pielietotiem kā biomarķieriem kognitīvo traucējumu izvērtēšanā, tomēr ir nepieciešami tālāki pētījumi un vienota pieeja DTI datu analīzei, lai tos varētu pielietot rutīnas izmeklējumos.
Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that provides data on the white matter connections and microstructural organisation of the brain. The basic principles of DTI are based on the movement of water molecules along nerve axons, which can be represented by both qualitative and quantitative data. Quantitative data or scalars (fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity) obtained by DTI can be used to assess the severity of a patient's cognitive impairment. The aim of this study was to investigate whether there is a relationship between quantitative DTI characteristics and cognitive performance. The study included 25 patients with variable cognitive abilities. Patients were assessed by a neurologist with the Montreal Cognitive Assessment (MoCA) test before imaging. Based on the scores obtained, the patients were divided into three subgroups (normal cognitive ability (NC), mild/moderate cognitive impairment (MCI) and severe cognitive impairment (SCI) ). Imaging was performed with 3.0 T MRI equipment. Diffusion images were processed with DSI studio software, from which quantitative information was extracted for the following regions: whole brain, forceps minor, corpus callosum, forceps major and fornix. The data was further grouped and analysed with JASP mathematical statistics software. Statistically significant differences were found in the AD of the whole brain region, this value was increased in the SCI group compared to NC (p<0.05) and was also increased in the SCI group compared to MCI (p<0.05). Statistically significant differences were found in MD when the corpus callosum was assessed, this value was increased in the SCI group compared to NC (p=0.003) and was also increased when the SCI group was compared to MCI (p=0.011). In the other brain regions examined, changes in quantitative values were also found, but were not statistically significant. The data obtained in this study suggest that the quantitative characteristics of DTI may be related to the cognitive performance of the patients. The findings are similar to existing studies on the application of diffusion tensor imaging in the diagnosis of various neurological diseases, including dementia. In the future, DTI quantitative characteristics have the potential to be used as biomarkers in the assessment of cognitive impairment, but further research and a unified approach to the analysis of DTI data are needed before they can be applied in routine examinations.
Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that provides data on the white matter connections and microstructural organisation of the brain. The basic principles of DTI are based on the movement of water molecules along nerve axons, which can be represented by both qualitative and quantitative data. Quantitative data or scalars (fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity) obtained by DTI can be used to assess the severity of a patient's cognitive impairment. The aim of this study was to investigate whether there is a relationship between quantitative DTI characteristics and cognitive performance. The study included 25 patients with variable cognitive abilities. Patients were assessed by a neurologist with the Montreal Cognitive Assessment (MoCA) test before imaging. Based on the scores obtained, the patients were divided into three subgroups (normal cognitive ability (NC), mild/moderate cognitive impairment (MCI) and severe cognitive impairment (SCI) ). Imaging was performed with 3.0 T MRI equipment. Diffusion images were processed with DSI studio software, from which quantitative information was extracted for the following regions: whole brain, forceps minor, corpus callosum, forceps major and fornix. The data was further grouped and analysed with JASP mathematical statistics software. Statistically significant differences were found in the AD of the whole brain region, this value was increased in the SCI group compared to NC (p<0.05) and was also increased in the SCI group compared to MCI (p<0.05). Statistically significant differences were found in MD when the corpus callosum was assessed, this value was increased in the SCI group compared to NC (p=0.003) and was also increased when the SCI group was compared to MCI (p=0.011). In the other brain regions examined, changes in quantitative values were also found, but were not statistically significant. The data obtained in this study suggest that the quantitative characteristics of DTI may be related to the cognitive performance of the patients. The findings are similar to existing studies on the application of diffusion tensor imaging in the diagnosis of various neurological diseases, including dementia. In the future, DTI quantitative characteristics have the potential to be used as biomarkers in the assessment of cognitive impairment, but further research and a unified approach to the analysis of DTI data are needed before they can be applied in routine examinations.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Demence, DTI, Kognitīvie traucējumi, MRI, Cognitive impairment, Dementia, DTI, MRI