Evaluated the value of MRI multi-sequence in brain lesions among AD patients based on hidden structure model and data mining
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摘要:
目的 基于隐结构模型及数据挖掘评估MRI多序列联合检查对阿尔茨海默病(AD)患者认知功能障碍程度的诊断价值。 方法 选取2021年1月—2024年8月绍兴市第七人民医院诊治的203例AD患者(AD组)和102例非AD患者(对照组)作为研究对象，并根据认知功能障碍程度将AD患者分为轻度组(86例)、中度组(72例)、重度组(45例)，观察患者MRI多序列联合检查情况。 结果 AD组海马体积和SN相位偏移值低于对照组，而ADC值较高(P＜0.05)。隐结构模型显示，ADC、海马体积、黑质结构相位偏移值与AD具有密切关联。Modeler数据挖掘结果显示，“高风险脑部病变特征聚类群”患者MMSE评分较高，但存在潜在病变风险；“显著脑部病变特征聚类群”患者病变特征更明显，MMSE评分较低。重度组患者的左侧、右侧海马体积、SN相位偏移值低于轻度、中度组，ADC高于轻度、中度组(P＜0.05)。AD患者的认知功能与海马体积、SN相位偏移值呈负相关关系，与ADC呈正相关关系(P＜0.05)。ROC曲线分析显示，海马体积、ADC、SN相位偏移值及多序列联合诊断AD患者重度认知功能障碍的AUC值分别为0.748、0.673、0.802、0.892。 结论 MRI多序列联合检查对评估AD患者认知功能障碍有一定价值，且结合隐结构模型及数据挖掘技术有利于为AD早期诊断和病情评估提供重要参考依据。 Abstract:Objective Evaluate the diagnostic value of MRI multi-sequence combined examination for the degree of cognitive dysfunction in patients with Alzheimer' s disease (AD) based on hidden structure models and data mining. Methods A total of 203 AD patients (AD group) and 102 non-AD patients (control group) diagnosed and treated at Shaoxing 7th People' s Hospital from January 2021 to August 2024 were selected as the subjects in this study. The AD patients were divided into the following three groups according to their degree of cognitive dysfunction: mild, moderate and severe. Results The hippocampal volume and SN phase shift values in the AD group were lower than those in the control group, while the ADC value was higher (P < 0.05). The implicit structure model demonstrates a close relationship between AD, ADC, hippocampal volume, and the phase shift value of substantia nigra structure. The results of the Modeler data mining show that patients in the "high-risk brain lesion feature cluster" have a higher MMSE score, however, there is a potential risk of lesion. Patients in the "significant brain lesion feature cluster" exhibit more pronounced lesion features and lower MMSE scores. The severity group exhibited reduced volumes of the left and right hippocampus and the SN phase shift value when compared to the mild and moderate groups, and the ADC value in the severity group was higher than observed in the mild and moderate groups (P < 0.05). The cognitive function of AD patients was found to be negatively correlated with hippocampal volume and SN phase shift value, and positively correlated with ADC (P < 0.05). ROC curve analysis demonstrated that the AUC values of hippocampal volume, ADC, SN phase shift, and multi-sequence combined diagnosis of severe cognitive dysfunction in AD patients were 0.748, 0.673, 0.802 and 0.892. Conclusion MRI multi-sequence combined examination has been shown to have a certain value in the evaluation of cognitive dysfunction in AD patients, and the combination of hidden structure models and data mining techniques has been demonstrated to be conducive to providing an important reference basis for the early diagnosis and condition assessment of AD. -
图 1 观察指标的隐结构模型图
Figure 1. Illustration of the latent structural model underlying the observation indicators
图 2 观察指标的隐变量信息曲线图
Figure 2. Illustration of the latent variable information underlying the observation indicators
图 3 2组患者临床指标两步聚类结果
Figure 3. Two-step clustering results of clinical indicators for the two patient groups
图 4 MRI多序列扫描诊断AD患者脑部病变的效能分析
Figure 4. Analysis of the diagnostic efficacy of multi-sequence MRI in detecting brain lesions in patients with AD
表 1 2组患者观察指标比较
Table 1. Comparison of observation Indicators between the two groups of patients
项目 AD组(n=203) 对照组(n=102) 统计量 P值 性别[例(%)] 0.015a 0.901 男性 109(53.69) 54(52.94) 女性 94(46.31) 48(47.06) 年龄(x±s，岁) 72.37±3.78 72.35±3.90 0.046b 0.963 BMI(x±s) 23.96±2.85 24.02±2.79 0.173b 0.863 吸烟史[例(%)] 72(35.47) 47(46.08) 3.212a 0.073 饮酒史[例(%)] 51(25.12) 32(31.37) 1.339a 0.247 空腹血糖(x±s，mmol/L) 5.96±1.25 6.02±1.32 0.386b 0.700 舒张压(x±s，mmHg) 85.99±4.99 85.94±5.09 0.080b 0.936 收缩压(x±s，mmHg) 132.07±7.50 132.10±7.50 0.027b 0.979 左侧海马体积(x±s，cm2) 2.38±0.72 3.08±0.92 7.288b ＜0.001 右侧海马体积(x±s，cm2) 2.85±0.77 3.51±0.78 7.045b ＜0.001 ADC(x±s) 9.73±1.77 8.72±1.28 5.118b ＜0.001 右侧SN相位偏移值(x±s) -0.177±0.024 -0.159±0.011 7.374b ＜0.001 左侧SN相位偏移值(x±s) -0.176±0.025 -0.157±0.013 6.991b ＜0.001 注：a为χ2值，b为t值；1 mmHg=0.133 kPa。 
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表 2 自动聚类模块数据挖掘结果
Table 2. Data mining results of the automated clustering module
模型 轮廓 聚类数 最小聚类(N) 最小聚类(%) 最大聚类(N) 最大聚类(%) 最小/ 最大 重要性 两步聚类 0.300 2 101 33 204 66 495 0.190 K-means聚类 0.186 5 42 13 8 26 0.519 0.141 Kohonen聚类 0.156 8 12 3 67 21 0.179 0.020
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表 3 不同认知功能障碍程度AD患者海马体积、ADC、SN相位偏移值比较(x±s)
Table 3. Comparison of hippocampal volume, ADC, and SN phase shift values in patients with different cognitive impairments(x±s)
组别 例数 左侧海马体积(cm2) 右侧海马体积(cm2) ADC 右侧SN相位偏移值 左侧SN相位偏移值 轻度组 86 2.65±0.79a 3.19±0.72a 9.02±1.42a -0.166±0.015a -0.165±0.016a 中度组 72 2.29±0.61a 2.90±0.66a 9.85±1.67a -0.179±0.021a -0.175±0.023a 重度组 45 2.00±0.54 2.12±0.50 10.88±1.89 -0.196±0.029 -0.197±0.030 F值 14.634 39.764 19.738 30.952 30.649 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 注：与重度组比较，aP＜0.05。
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表 4 AD患者认知功能障碍程度与海马体积、ADC、SN相位偏移值的相关性分析
Table 4. Correlation analysis between the severity of cognitive dysfunction in AD patients and hippocampal volume, ADC, and SN phase-shift values
变量 r值 P值 海马体积 -0.562 ＜0.001 ADC 0.389 ＜0.001 SN相位偏移值 -0.638 ＜0.001
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表 5 MRI多序列扫描诊断AD患者脑部病变的效能分析
Table 5. Analysis of the diagnostic performance of multi-sequence MRI in detecting brain lesions in AD patients
检验结果变量 AUC 95% CI 标准误 P值 约登指数 灵敏度 特异度 海马体积 0.748 0.690~0.806 0.030 ＜0.001 0.372 87.20 50.00 ADC 0.673 0.613~0.734 0.031 ＜0.001 0.345 45.30 89.20 SN相位偏移值 0.802 0.752~0.853 0.026 ＜0.001 0.548 75.40 79.40 多序列联合 0.892 0.858~0.927 0.018 ＜0.001 0.650 76.80 88.20
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[1] ORNISH D, MADISON C, KIVIPELTO M, et al. Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer' s disease: a randomized, controlled clinical trial[J]. Alzheimers Res Ther, 2024, 16(1): 122. DOI: 10.1186/s13195-024-01482-z. [2] 李伟英, 林青, 傅攀. 血浆Aβ1-40及血脂与炎性指标在阿尔茨海默病患者中的表达及意义[J]. 中华全科医学, 2021, 19(12): 2048-2050, 2118. doi: 10.16766/j.cnki.issn.1674-4152.002233LI W Y, LIN Q, FU P. Expression and significance of plasma aβ1-40, blood lipid and inflammatory indexes in Alzheimer's disease[J]. Chinese Journal of General Practice, 2021, 19(12): 2048-2050, 2118. doi: 10.16766/j.cnki.issn.1674-4152.002233 [3] YE J R, WU C X, CHEN J, et al. Effectiveness of nurse-delivered stepwise swallowing training on dysphagia in patients with Alzheimer' s disease: a multi-center randomized controlled trial[J]. Int J Nurs Stud, 2024, 150: 104649. DOI: 10.1016/j.ijnurstu.2023.104649. [4] 陈昱, 陈大才, 陈薪宇, 等. MRI应用于阿尔茨海默病、血管性痴呆、混合型痴呆患者中血管损伤与脑萎缩评估的研究[J]. 中国CT和MRI杂志, 2024, 22(2): 18-21.CHEN Y, CHEN D C, CHEN X Y, et al. Vascular lesions and brain atrophy in dementia: an optimized mri protocol reveals distinctive radiological profiles[J]Chinese Journal of CT and MRI, 2024, 22(2): 18-21. [5] 侯伟丽, 马兰. 阿尔茨海默病诊断研究进展[J]. 中华实用诊断与治疗杂志, 2020, 34(4): 417-419.HOU W L, MA L. Diagnosis of Alzheimer's disease[J]. Journal of Chinese Practical Diagnosis and Therapy, 2020, 34(4): 417-419. [6] 中国老年保健协会阿尔茨海默病分会, 中国中药协会脑病药物研究专业委员会. 阿尔茨海默病中西医结合诊疗中国专家共识[J]. 中华行为医学与脑科学杂志, 2024, 33(2): 97-108.Alzheimer' s Disease Committee of Chinese Aging Well Association, Encephalopathy Drug Research Committee of China Association of Traditional Chinese Medicine. Chinese expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of Alzheimer' s disease[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2024, 33(2): 97-108. [7] 岑伟. 简易精神状态检查法与修订的长谷川痴呆量表的临床应用[J]. 神经病学与神经康复学杂志, 2006, 3(4): 207-209.CEN W. Clinical use of mini mental status examination and revised nagatanikawa dementia scale[J]. Journal of Neurology and Neurorehabilitation, 2006, 3(4): 207-209. [8] 熊雪颖, 梅豪, 叶乃力, 等. 3.0 T MRI测定海马体积、嗅球容积、嗅沟深度与早期阿尔茨海默病的相关性[J]. 磁共振成像, 2020, 11(10): 858-861.XIONG X Y, MEI H, YE N L, et al. 3.0 T MRI determination of hippocampus volume, olfactory bulb volume and cognitive impairment in Alzheimer' s disease patients[J]. Chinese Journal of Magnetic Resonance Imaging, 2020, 11(10): 858-861. [9] 韦卓男, 樊响, 余可妍, 等. 结构MRI联合基于VR眼动追踪技术的计算机化认知评估在阿尔茨海默病早期诊断中的应用价值[J]. 磁共振成像, 2024, 15(6): 49-53.WEI Z N, FAN X, YU K Y, et al. Application value of structural MRI combined with computerized cognitive assessment based on VR eye-tracking technology in early diagnosis of Alzheimer' s disease[J]. Chinese Journal of Magnetic Resonance Imaging, 2024, 15(6): 49-53. [10] 暴丽洁, 赵子龙, 苏宁, 等. MRI和PET显像在阿尔茨海默病早期诊断中的应用[J]. 国际放射医学核医学杂志, 2023, 47(4): 249-253.BAO L J, ZHAO Z L, SU N, et al. Application of MRI and PET imaging in early diagnosis of Alzheimer disease[J]. International Journal of Radiation Medicine and Nuclear Medicine, 2023, 47(4): 249-253. [11] TOMASZEWSKI FARIAS S, FOX J, DULANEY H, et al. Memory support training and lifestyle modifications to promote healthy aging in persons at risk for Alzheimer' s disease: a digital application supported intervention (Brain Boosters)[J]. BMC Geriatr, 2023, 23(1): 881. DOI: 10.1186/s12877-023-04574-x. [12] 吴永彬, 焦金粉, 李萍. 阿尔茨海默病和轻度认知障碍患者海马区MRI表现及其与认知功能的关系[J]. 宁夏医科大学学报, 2022, 44(9): 898-902.WU Y B, JIAO J F, LI P. Comparison of mri findings in hippocampus of patients with Alzheimer's disease and mild cognitive impairment and its relationship with cognitive function[J]. Journal of Ningxia Medical University, 2022, 44(9): 898-902. [13] 刘瑜, 曹志宏, 罗一烽, 等. 轻度阿尔茨海默病患者治疗前后海马亚区体积的磁共振成像研究[J]. 中国康复理论与实践, 2020, 26(5): 592-596.LIU Y, CAO Z H, LUO Y F, et al. Hippocampal subfield volumes before and after treatment for mild Alzheimer's disease: study with magnetic resonance imaging[J]. Chinese Journal of Rehabilitation Theory and Practice, 2020, 26(5): 592-596. [14] 潘名志, 徐晓文, 孙洪言, 等. 血清25羟维生素D水平、海马MRI与阿尔茨海默病患者认知功能相关性的研究[J]. 浙江医学, 2022, 44(23): 2559-2561.PAN M Z, XU X W, SUN H Y, et al. Study on the correlation between serum 25-hydroxyvitamin D levels, hippocampal mri and cognitive function in patients with Alzheimer'' s disease[J]Zhejiang Medical Journal, 2022, 44(23): 2559-2561. [15] 胡晨玲, 张学平, 杨荣梅, 等. 阿尔茨海默病患者血清补体C5a水平及其与炎症因子的相关性[J]. 中华全科医学, 2020, 18(5): 760-762. doi: 10.16766/j.cnki.issn.1674-4152.001349HU C L, ZHANG X P, YANG R M, et al. Serum complement c5a levels and its association with inflammatory factors in patients with Alzheimer's disease[J]. Chinese Journal of General Practice, 2020, 18(5): 760-762. doi: 10.16766/j.cnki.issn.1674-4152.001349 [16] 王前香, 吴雪峰, 徐华, 等. 基于磁敏感加权成像探讨老年帕金森病患者脑微出血灶与认知障碍的关系[J]. 中华老年心脑血管病杂志, 2024, 26(10): 1173-1177.WANG Q X, WU X F, XU H, et al. Relationship between cerebral microbleeds and cognitive impairment in elderly pd patients based on MRI susceptibility weighted imaging[J]. Chinese Journal of Geriatric Heart, Brain and Vessel Diseases, 2024, 26(10): 1173-1177. [17] 俞凯佳, 邬远洋, 姚麒, 等. 磁敏感加权成像在帕金森病脑深部电刺激术中定位丘脑底核的效果分析[J]. 中华神经外科杂志, 2025, 41(4): 389-394.YU K J, WU Y Y, YAO Q, et al. Analysis of the effectiveness of susceptibility weighted imaging in locating the subthalamic nucleus during deep brain stimulation in Parkinson' s disease[J]. Chinese Journal of Neurosurgery, 2020, 41(4): 389-394. [18] 张聪, 郑阳, 王晓明. 阿尔茨海默病患者APT、SWI与MMSE相关应用研究[J]. 磁共振成像, 2020, 11(6): 406-410.ZHANG C, ZHENG Y, WANG X M. Correlation between MMSE and amido proton transfer, susceptibility-weighted imaging in Alzheimer' s disease[J]. Chinese Journal of Magnetic Resonance Imaging, 2020, 11(6): 406-410. -
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