目的 通过定量磁敏感成像技术（quantitative susceptibility mapping，QSM）探讨阿尔茨海默病（Alzheimer's disease，AD）患者脑铁含量与认知功能的相关性并评估铁沉积对AD的诊断价值。 方法 选取2024年1—12月就诊于新疆医科大学第二附属医院的AD患者43例和与其性别、年龄相匹配的健康对照人群42例，收集所有受试者的一般临床资料，采用飞利浦Ingenia CX 3.0T磁共振对所有受试者行QSM和常规颅脑MRI序列扫描，用STISuite对收集到的QSM影像资料进行后处理和标准化，然后通过ITK-SNAP软件测出感兴趣区（region of interest，ROI）铁含量。对所有受试者进行神经心理学评估，比较AD患者与健康对照人群脑内ROI铁含量差异，使用Spearman相关性分析来分析额叶皮质、基底节区、海马铁含量与认知功能的相关性，绘制ROC曲线评估铁沉积对AD的诊断价值。 结果 （1）与对照组比较，AD组基底节区及海马磁敏感值差异有统计学意义（P < 0.01），且AD组磁敏感值更高；AD组与对照组的额叶皮质磁敏感值差异无统计学意义（P > 0.05）。（2）AD组左侧尾状核、左侧海马尾磁敏感值与MMSE评分呈负相关（P < 0.05），左侧尾状核、左侧壳核、左侧海马体、左侧海马尾磁敏感值与MOCA评分呈负相关（P < 0.05）。（3）左侧尾状核诊断AD的曲线下面积为0.758（95%CI：0.649 ~ 0.867）；左侧壳核诊断AD的曲线下面积为0.719（95%CI：0.606 ~ 0.831）；左侧海马尾诊断AD的曲线下面积为0.64（95%CI：0.518 ~ 0.763）。 结论 （1）AD患者大脑特定脑区的铁含量较健康同龄人增多，尤其在基底节区及海马部位增多明显。（2）AD患者脑内铁浓度特别是左侧尾状核、左侧壳核、左侧海马体、左侧海马尾的铁含量与认知功能呈负相关，其水平越高认知功能越差，可能是评估疾病严重程度的潜在标准之一。（3）左侧尾状核和左侧壳核铁沉积对AD有一定的诊断价值，有望成为AD辅助诊断的影像学标记物。

Objective To investigate the correlation between brain iron content and cognitive function in patients with Alzheimer's disease （AD）， and to assess the diagnostic value of iron deposition in AD using quantitative susceptibility mapping （QSM） technology. Methods Forty-three patients with AD who visited the Second Affiliated Hospital of Xinjiang Medical University between January 2024 and December 2024， and 42 healthy controls matched for gender and age were enrolled in the study. Comprehensive clinical data were collected from all participants. All subjects underwent brain MRI scans using a Philips Ingenia CX 3.0T magnetic resonance imaging system， including both QSM and conventional cranial MRI sequences. The acquired QSM images were post-processed and normalized using the STISuite software package， and the iron content in predefined regions of interest was quantified using ITK-SNAP. All participants also underwent neuropsychological assessments. Differences in regional brain iron content between AD patients and healthy controls were analyzed and compared. Spearman’s correlation coefficient was calculated to evaluate the relationship between iron levels in the frontal cortex， basal ganglia， and hippocampus and cognitive performance. Receiver operating characteristic （ROC） curves were constructed to assess the diagnostic accuracy of iron deposition in differentiating AD patients from healthy controls. Results （1） Compared with the control group， the magnetic susceptibility values in the basal ganglia and hippocampus of the AD group showed statistically significant differences （P < 0.01）， with higher values observed in the AD group. No statistically significant difference was found in the susceptibility values of the frontal cortex between the AD group and the control group （P > 0.05）. （2） In the AD group， the susceptibility values of the left caudate nucleus and left hippocampus tail were negatively correlated with the MMSE scores （P < 0.05）. Additionally， the susceptibility values of the left caudate nucleus， left putamen， left hippocampus， and left hippocampus tail were negatively correlated with the MOCA scores （P < 0.05）. （3） The area under the curve （AUC） for diagnosing AD based on the left caudate nucleus was 0.758 （95%CI： 0.649–0.867）， for the left putamen it was 0.719 （95%CI： 0.606–0.831）， and for the left hippocampus tail it was 0.640 （95%CI： 0.518–0.763）. Conclusions （1） The iron content in certain brain regions of AD patients is elevated compared to that in healthy controls， particularly in the basal ganglia and hippocampus. （2） The iron concentration in the brains of AD patients， especially in the left caudate nucleus， left putamen， left hippocampus， and hippocampal tail， is negatively correlated with cognitive function. Higher iron levels are associated with more severe cognitive impairment， suggesting that iron accumulation may serve as a potential biomarker for assessing disease severity. （3） Iron deposition in the left caudate nucleus and left putamen demonstrates certain diagnostic value for AD and holds promise as an imaging marker for the auxiliary diagnosis of the disease.