赵江民，詹 青. 上海交通大学医学院附属第九人民医院医学影像科，上海 0900；. 上海中医药大学附属第七人民医院神经内科，上海 0037



综述Review

MRI早期诊断阿尔茨海默病的研究进展

赵江民1，詹 青2
1. 上海交通大学医学院附属第九人民医院医学影像科，上海 201900；
2. 上海中医药大学附属第七人民医院神经内科，上海 200137

摘要

关键词：阿尔茨海默病；早期诊断；磁共振成像

赵江民，詹 青. MRl早期诊断阿尔茨海默病的研究进展［J］. 神经病学与神经康复学杂志， 2016， 12（1）:47–51.

FUNDlNG/SUPPORT: Key Project of Scientific & Technological lnnovation Action Program Supported by Science and Technology Commission of Shanghai Municipality （No. 10411953400）； Research Project Supported by Baoshan District Association for Science & Technology， Shanghai （No. 14–E–4）； Medical Guidance Project of Science and Technology Commission of Shanghai Municipality （No. 114119a5800）

CONFLlCT OF lNTEREST: The authors have indicated they have no conflicts of interest to disclose.

Received Feb. 1， 2016； accepted for publication Mar. 1， 2016

Copyright © 2016 by Journal of Neurology and Neurorehabilitation

ZHAN Qing

E-MAIL ADDRESS

zhanqing@tongji.edu.cn

ABSTRACT

With the aging of global population， the incidence of Alzheimer’s disease （AD） shows a significant upward trend. So far， there is still a lack of effective treatment for AD， and diagnosis，prevention and treatment in early stage of AD is the only effective way to delay the progression of AD. Currently， the diagnosis of AD still mainly relies on the exclusive method and clinical neuropsychological scales with poor repeatability and being absent of objective evidence，lacking sensitive and accurate methods for early diagnosis of AD. With the development of medical imaging technology， "medical imaging+" transdisciplinary research has become the new norm， the interdisciplinary neuroimaging techniques can clearly show the finer structures and lesions in the brain， which provides a basis for the early diagnosis of AD. Due to the loss ofneurons in brain tissues of patients with AD， cerebral atrophy is developed， so the AD can be observed by measuring the degree of cerebral atrophy. This paper summarizes the research progress in measurement of hippocampal volume， entorhinal cortex thickness and the change of amygdale through magnetic resonance imaging （MRI）， the application of double inversion recovery （DIR） sequence in diagnosis of AD， and the role of diffusion tensor imaging （DTI） in the assessment of injury in white matter related to hippocampus.

To cite: ZHAO J M， ZHAN Q. Advances in MRl in diagnosis of early–stage Alzheimer’s disease. J Neurol and Neurorehabil， 2016， 12（1）:47–51.

阿尔茨海默病（Alzheimer's disease，AD）的主要临床表现包括认知功能障碍、日常生活能力下降和精神行为障碍。AD发病初期主要表现为以近期遗忘及学习和记忆新知识能力减退为特点的近期记忆力下降；随着病情的进展，逐渐出现计算困难、远期记忆障碍、时间及空间定向障碍、语言障碍、思维能力下降、理解及判断能力下降以及情感障碍等认知和行为障碍［1］。AD的特征性病理表现包括老年斑（senile plaque，SP）、神经原纤维缠结（neurofibrillary tangle，NFT）以及神经元及神经突触的丧失；此外，还包括神经元颗粒空泡变性和血管壁淀粉样蛋白变性［2］。

目前尚不清楚AD的确切病因及发病机制，相关学说包括遗传学说、异常蛋白沉积学说、微管相关蛋白tau异常学说、神经递质变化学说以及微量元素变化学说等［3-4］。目前对于AD的诊断仍主要依据排除法和临床神经心理量表法，但其可重复性差，且缺乏客观依据。

近年来的研究发现，在AD的轻度认知障碍（mild cognition impairment，MCI）阶段及AD早期，患者的脑组织结构即表现出广泛且较为明显的变化［5-6］。……