The Combination of Presurgical Cortical Gray Matter Volumetry and Cerebral Perfusion Improves the Efficacy of Predicting Postoperative Cognitive Impairment of Elderly Patients.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-09-01 DOI:10.3390/tomography10090104

Weijian Zhou, Binbin Zhu, Yifei Weng, Chunqu Chen, Jiajing Ni, Wenqi Shen, Wenting Lan, Jianhua Wang

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Abstract

Background: Postoperative cognitive dysfunction (POCD) is a common complication of the central nervous system in elderly surgical patients. Structural MRI and arterial spin labelling (ASL) techniques found that the grey matter volume and cerebral perfusion in some specific brain areas are associated with the occurrence of POCD, but the results are inconsistent, and the predictive accuracy is low. We hypothesised that the combination of cortical grey matter volumetry and cerebral blood flow yield higher accuracy than either of the methods in discriminating the elderly individuals who are susceptible to POCD after abdominal surgery.

Materials and methods: Participants underwent neuropsychological testing before and after surgery. Postoperative cognitive dysfunction (POCD) was defined as a decrease in cognitive score of at least 20%. ASL-MRI and T1-weighted imaging were performed before surgery. We compared differences in cerebral blood flow (CBF) and cortical grey matter characteristics between POCD and non-POCD patients and generated receiver operating characteristic curves.

Results: Out of 51 patients, 9 (17%) were diagnosed with POCD. CBF in the inferior frontal gyrus was lower in the POCD group compared to the non-POCD group (p < 0.001), and the volume of cortical grey matter in the anterior cingulate gyrus was higher in the POCD group (p < 0.001). The highest AUC value was 0.973.

Conclusions: The combination of cortical grey matter volumetry and cerebral perfusion based on ASL-MRI has improved efficacy in the early warning of POCD to elderly abdominal surgical patients.

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术前皮质灰质容积测量与脑灌注相结合可提高老年患者术后认知功能障碍的预测效果

背景：术后认知功能障碍（POCD）是老年手术患者中枢神经系统的常见并发症。结构磁共振成像（MRI）和动脉自旋标记（ASL）技术发现，某些特定脑区的灰质体积和脑血流灌注与 POCD 的发生有关，但结果并不一致，而且预测准确性较低。我们假设，在鉴别腹部手术后易患 POCD 的老年人时，将皮层灰质体积测量和脑血流测量结合使用的准确性要高于其中任何一种方法：参与者在手术前后接受了神经心理学测试。术后认知功能障碍（POCD）的定义是认知评分下降至少 20%。术前进行了 ASL-MRI 和 T1 加权成像。我们比较了认知功能障碍患者和非认知功能障碍患者脑血流（CBF）和皮质灰质特征的差异，并生成了接收器操作特征曲线：在 51 名患者中，9 人（17%）被诊断为 POCD。与非 POCD 组相比，POCD 组患者额叶下回的 CBF 更低（P < 0.001），POCD 组患者扣带回前部的皮质灰质体积更大（P < 0.001）。AUC最高值为0.973.结论：基于 ASL-MRI 的皮质灰质容积测量和脑灌注相结合，对老年腹部手术患者的 POCD 早期预警具有更好的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.