中文摘要：

目的 通过分析颅脑磁共振（MRI）弥散加权成像（DWI）、扩散张量成像（DTI）表现及血清学指标与认知功能量表得分，探讨肾性继发性甲状旁腺功能亢进症（SHPT）患者认知功能变化与 MRI 表现之间的关系。方法 选取肾性 SHPT 住院患者 49 例，采用 MoCA 及 MMSE 功能量表评价认知功能，使用颅脑 MRI 扫描并选用部分异向性（FA）、表观弥散系数（ADC）评价各脑功 能区白质功能，同时记录血清检验指标，统计并分析认知功能评分与各脑白质功能区 MRI 得分及生化指标间的相关性。结果 肾性 SHPT 患者额叶区 FA 及 ADC 得分与 MMSE 语言、记忆功能得分相关，顶叶区 FA 及 ADC 评分与 MoCA 视空间执行能力得分 相关，其余各功能区 MRI 得分与认知功能量表得分之间无明显相关性。肾性 SHPT 患者认知功能与全段甲状旁腺素（iPTH）水平呈负相关，与受教育水平呈正相关，与性别、年龄、血压、血清钙水平等无明显相关性。结论 肾性 SHPT 患者 iPTH 及受教育 水平与认知功能存在相关性；颅脑 MRI 的额叶及顶叶 FA 与 ADC 值对判断肾性 SHPT 患者认知功能水平及功能损伤定位具有较 高的诊断价值，值得临床推广。

英文摘要：

Objective To investigate the relationship between cognitive function and magnetic resonance imaging （MRI） manifestations in pa- tients with secondary hyperparathyroidism （SHPT） by analyzing brain MRI diffusion-weighted imaging, diffusion tensor imaging, serological mark- ers, and cognitive function. Methods We evaluated 49 random patients with SHFF. We adopted two functional scales to evaluate cognitive fune- tion and performed MRI fractional anisotropy （FA） and apparent diffusion coe/fieient （ADC） to evaluate white matter function of brain functional areas. We recorded serological markers, and conducted statistical analysis to analyze correlation among cognitive function scores, brain MRI in white matter functional areas, and biochemical parameters. Results We found that at the frontal area, the FA and ADC values were correlated with the MMSE language and memory function scores ; at the parietal area, the FA and ADC values were correlated to the MoCA visuospatial execu- tive function scores ; the other areas had no significant correlation with cognitive function scale score. Cognitive function was negatively correlated with immunoreactive parathyroid hormone （iFFH） levels but positively correlated with education level, while it was not correlated with sex, age, blood pressure, and serum calcium levels in patients with SHP-F. Conclusion In patients with SHPT, cognitive function is correlated with iFFH level and education level. The FA and ADC values of brain MRI in the frontal and parietal lobes might play a diagnostic role in evaluating cognitive function and locating injury for patients with SHPT, which requires clinical attention.