酰胺质子转移磁共振成像在阿尔茨海默病早期诊断中的研究

doi:10.3969/j.issn.1003-9198.2026.02.012

摘要/Abstract

摘要： 目的探讨酰胺质子转移(APT)磁共振成像技术在AD早期诊断中的应用价值。方法前瞻性收集22例AD病人(AD组)、25例轻度认知功能障碍病人(MCI组)、20例年龄及性别相匹配的健康对照者(NC组)进行头颅常规磁共振结构成像和海马区APT成像检查。在斜轴位APT成像上测量双侧海马、颞叶皮层的酰胺质子(3.5 ppm处)不对称磁化转移率(MTR_asym)。采用单因素方差分析比较3组间海马区及颞叶皮层MTR_asym(3.5 ppm)的差异。所有受试者均接受MMSE量表评估,以年龄和受教育时间为控制变量,采用偏相关分析比较所有受试者海马结构MTR_asym(3.5 ppm)与MMSE评分的相关性。结果 NC组、MCI组和AD组双侧海马的MTR_asym(3.5 ppm)依次增高,差异均具有统计学意义,其中左侧海马:0.84±0.26,1.12±0.24,1.56±0.31(F=15.463,P＜0.001);右侧海马:0.86±0.17,1.16±0.26,1.51±0.21(F=17.221, P＜0.001)。同一组别下两侧间海马、颞叶皮层的MTR_asym(3.5 ppm)差异均无统计学意义(P＞0.05)。3组间双侧颞叶皮层的MTR_asym(3.5 ppm)差异均无统计学意义(P＞0.05)。所有对象双侧海马的MTR_asym(3.5 ppm)均与MMSE评分呈负相关(左侧r=-0.627,P＜0.001;右侧r=-0.614,P＜0.001)。结论 APT成像可量化海马代谢异常,其MTR_asym(3.5 ppm)与AD病情进展及认知功能显著相关,对AD早期诊断及病情监测具有临床价值。

关键词: 酰胺质子转移, 阿尔茨海默病, 轻度认知障碍, 海马, 颞叶皮层

Abstract: Objective To explore the application value of amide proton transfer (APT) magnetic resonance imaging (MRI) in the early diagnosis of Alzheimer’s disease (AD). Methods A total of 22 AD patients (AD group), 25 patients with mild cognitive impairment (MCI group), and 20 age- and gender-matched healthy controls (NC group) were prospectively enrolled. All subjects underwent routine cranial MRI structural imaging and hippocampal APT imaging. The amide proton (3.5 ppm) asymmetry magnetization transfer rate (MTR_asym) of bilateral hippocampi and temporal cortices was measured on oblique axial APT images. One-way analysis of variance was used to compare MTR_asym(3.5 ppm) among the three groups. The Mini-Mental State Examination (MMSE) was administered to all subjects, and partial correlation analysis was performed to evaluate the correlation between hippocampal MTR_asym(3.5 ppm) and MMSE score, with age and educational duration as control variables. Results The level of MTR_asym(3.5 ppm) of bilateral hippocampi increased sequentially in the NC, MCI, and AD groups: left hippocampus 0.84±0.26, 1.12±0.24, 1.56±0.31 (F=15.463, P＜0.001), right hippocampus 0.86±0.17, 1.16±0.26, 1.51±0.21 (F=17.221, P＜0.001). No significant interhemispheric differences of MTR_asym(3.5 ppm) of bilateral hippocampi and temporal cortex were observed within each group (P＞0.05). No significant differences in bilateral temporal cortex MTR_asym(3.5 ppm) were found among the three groups (P＞0.05). MTR_asym(3.5 ppm) of bilateral hippocampi were negatively correlated with MMSE scores (left: r=-0.627, P＜0.001; right: r=-0.614, P＜0.001). Conclusions APT imaging can quantify hippocampal metabolic abnormalities, and its MTR_asym(3.5 ppm) is significantly correlated with AD progression and cognitive function, demonstrating clinical value for early AD diagnosis and disease monitoring.

Key words: amide proton transfer, Alzheimer’s disease, mild cognitive impairment, hippocampus, temporal cortex

中图分类号:

罗静, 张玉峰, 高晓龙, 顾国军. 酰胺质子转移磁共振成像在阿尔茨海默病早期诊断中的研究[J]. 实用老年医学, 2026, 40(2): 164-168.

LUO Jing, ZHANG Yufeng, GAO Xiaolong, GU Guojun. Application of amide proton transfer magnetic resonance imaging in early diagnosis of Alzheimer’s disease[J]. Practical Geriatrics, 2026, 40(2): 164-168.

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