抑郁症患者的脑CT灌注成像特征与认知功能的相关性

摘要 目的：探讨抑郁症患者的脑CT灌注成像特征与认知功能的相关性。方法：选取我院2020年1月到2023年1月收治的90例抑郁症患者作为研究对象，将其分为观察组，另选取同期来我院体检的90名健康志愿者作为对照组。收集所有受检者脑CT灌注成像检查数据，分析抑郁症患者的脑CT灌注成像特征，并建立受试者工作特征（ROC）曲线分析脑CT灌注成像对抑郁症的诊断效能。随后对观察组和对照组受检者均进行认知功能评估，其中包括连线检测（TMT）、视觉再生测验（VRT）、言语流畅性测验（VF）、数字广度测验（DST）以及数字符号测验（SDMT），并分析脑CT灌注成像与抑郁症认知功能的相关性。结果：观察组与对照组受检者rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值对比无明显差异（P＞0.05），观察组与对照组受检者右额叶、左额叶CT值对比差异显著，观察组明显低于对照组（P＜0.05）；90例抑郁症患者经过汉密尔顿抑郁量表（HAMD）评估后分数均＞20分，确定存在抑郁症状，脑CT灌注成像与HAMD评分诊断抑郁症的准确性、灵敏度、特异性、阳性预测值和阴性预测值对比无明显差异（P＞0.05），脑CT灌注成像的曲线下面积为83.89，最佳诊断着色界限值为82.53%，HAMD评分的曲线下面积为84.26，最佳诊断着色界限值为87.57%；观察组与对照组受检者连线提笔数、连线错误数、视觉再生检测结果对比无明显差异（P＞0.05），观察组与对照组受检者连线、言语流畅性、数字广度、数字符号检测结果对比差异显著（P＜0.05）；Spearman相关分析结果表明：连线提笔数、连线错误数、视觉再生与脑CT灌注参数均无明显相关性（P＞0.05），连线、言语流畅性、数字广度、数字符号与rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值无明显相关性（P＞0.05），连线与右额叶、左额叶CT值呈负相关（P＜0.05），言语流畅性、数字广度、数字符号与右额叶、左额叶CT值呈正相关（P＜0.05）。结论：抑郁症患者的脑CT灌注成像与健康群体呈现差异，其中右额叶、左额叶差异情况最为显著，提示抑郁症患者可能存在大脑额叶功能改变，另外，抑郁症患者的大脑额叶功能与认知功能变化具有明显相关性。

Correlation between Brain CT Perfusion Imaging Features and Cognitive Function in Patients with Depression

ABSTRACT Objective: To explore the correlation between brain CT perfusion imaging features and cognitive function in patients with depression. Methods: 90 depression patients admitted to our hospital from January 2020 to January 2023 were selected as the study subjects and divided into an observation group. Additionally, 90 healthy volunteers who came to our hospital for physical examination during the same period were selected as the control group. Collect brain CT perfusion imaging data from all subjects, analyze the characteristics of brain CT perfusion imaging in patients with depression, and establish a receiver operating characteristic (ROC) curve to analyze the diagnostic efficacy of brain CT perfusion imaging in depression. Subsequently, cognitive function assessments were conducted on both the observation and control groups, including Connection detection (TMT), Visual Regeneration Test (VRT), Speech fluency test (VF), Digit span test (DST), and Digit Symbol (SDMT), And analyze the correlation between brain CT perfusion imaging and cognitive function in depression. Results: There was no significant difference in the CT values of rCBV, rCBF, MTT, TIP, right occipital lobe, left occipital lobe, right temporal lobe, left temporal lobe, right parietal lobe, and left parietal lobe between the observation group and the control group (P>0.05). The CT values of the right frontal lobe and left frontal lobe between the observation group and the control group were significantly different, and the observation group was significantly lower than the control group (P<0.05); 90 patients with depression were evaluated by the Hamilton Depression Scale (HAMD) and their scores were all greater than 20 points, indicating the presence of depressive symptoms. There was no significant difference in the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value between brain CT perfusion imaging and HAMD score in diagnosing depression (P>0.05). The area under the curve of brain CT perfusion imaging was 83.89, the optimal diagnostic coloring limit was 82.53%, and the area under the curve of HAMD score was 84.26, The optimal diagnostic coloring threshold is 87.57%; There was no significant difference (P>0.05) between the observation group and the control group in the number of pen connections, number of connection errors, and visual regeneration test results. However, there was a significant difference (P<0.05) between the observation group and the control group in connection, speech fluency, number breadth, and number symbol test results; The Spearman correlation analysis results showed that there was no significant correlation between the number of line connections, line errors, visual regeneration, and brain CT perfusion parameters (P>0.05). Line connections, speech fluency, number span, and number symbols were negatively correlated with rCBV, rCBF, MTT, TIP, right occipital lobe, left occipital lobe, right temporal lobe, left temporal lobe, right parietal lobe, and left parietal lobe CT values (P>0.05), while line connections were negatively correlated with right frontal lobe and left frontal lobe CT values (P<0.05), There is a positive correlation between speech fluency, numerical breadth, and numerical symbols with CT values in the right and left frontal lobes (P<0.05). Conclusion: There are differences in brain CT perfusion imaging between patients with depression and the healthy population, with the most significant differences in the right and left frontal lobes. This suggests that there may be changes in brain frontal lobe function in patients with depression. In addition, there is a significant correlation between brain frontal lobe function and cognitive function changes in patients with depression.