摘要目的 探讨磁共振成像(M RI)的全脑整体健康水平评价指数(brain atrophy and lesion index,BALI)在脑老龄化评估中的应用. 方法 将169例40~89岁的健康人群分为5个年龄组,分别为40~49岁、50~59岁、60~69岁、70~79岁、80~89岁.采用3.0T GE signa采集 T1WI、T2WI、T2-FLAIR、T2*GRE序列,应用BALI指数对不同成像序列中的不同部位脑结构改变的数目、大小进行分级半定量评估. 结果 T1WI、T2WI、T2-FLAIR、T2*GRE4个序列的BALI总分均随增龄而增长,5个年龄组间BALI总分差异均有统计学意义(F=35.35、42.87、46.57、54.15,均 P=0.000);且相关性分析结果显示,4个序列的BALI总分均与年龄呈正相关(T1WI:r=0.71,T2WI:r=0.73,T2-FLAIR:r=0.73,T2*GRE:r=0.77,均 P<0.01).T2*GRE序列可检出微出血病灶,而T2-FLAIR序列于深部白质(χ2 = 53.47,P= 0.000)和侧脑室周围白质病变(χ2 = 29.93,P=0.000)检出更为敏感. 结论 T1WI、T2WI、T2-FLAIR 和 T2*GRE 序列的BALI评分可以评价整体脑结构老龄化改变,为全脑健康水平评价提供量化指标.

abstractsObjective To assess the value of brain atrophy and lesion index(BALI),based on magnetic resonance imaging(M RI),in the evaluation of brain aging. Methods 169 healthy older adults were divided into five age groups(40-49,50-59,60-69,70-79,and 80-89 years).MRI scans were evaluated by the 3.0T GE signa and the BALI rating schemes,based on the T1 weighted(T1WI),T2 weighted(T2WI),and T2 weighted fluid attenuated inversion recovery(T2-FLAIR),and T2*weighted gradient-recalled echo(T2 * GRE)images were recorded. Results Based on T1WI,T2WI,T2-FLAIR and T2 * GRE,total scores of BALI increased with age,and showed significant differences between the five age groups(F= 35.35,42.87,46.57,and 54.15,respectively;all P= 0.000).In addition,BALI scores from each sequence were correlated with age(T1WI:r=0.71;T2WI:r=0.73;T2-FLAIR:r=0.73;T2*GRE:r=0.77;all P<0.01).Furthermore,T2*GRE was most sensitive to microbleeds and T2-FLAIR revealed a greater level of deep white matter(χ2 =53.47,P= 0.000)and periventricular lesions(χ2 =29.93,P=0.000)than other sequences. Conclusions The T1WI,T2WI, T2-FLAIR and T2 * GRE,BALI scores can be used to assess whole brain structural changes with aging and provide semi-quantitative indicators for the assessment of brain health.