Pathologic correlates of diffusion MRI changes in Creutzfeldt-Jakob disease
Pathologic correlates of diffusion MRI changes in Creutzfeldt-Jakob disease
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DOI：
10.1212/wnl.0b013e3181a18846
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发表时间：
2009-04-21
期刊：
影响因子：
9.9
通讯作者：
Barbiroli, B.
中科院分区：
文献类型：
--
作者：
Manners, D. N.;Parchi, P.;Barbiroli, B.
目的：克雅氏病（CJD）患者特定脑区的高信号磁共振改变和表观扩散系数（ADC）降低的原因尚不清楚。我们的目的是确定的神经病理学相关性的生前水ADC值和归一化T2加权变化的患者CJD.Method：10例CJD和10名性别和年龄匹配的健康对照组进行了研究DWI和T2加权回波平面MRI。在尸检中，CJD患者进行了评价，半定量评估胶质细胞增生和神经元丢失，海绵状变化，异常PrP蛋白沉积在四个皮质区域（枕，顶叶，颞叶皮质，扣带回），丘脑和纹状体共60个区域的利益（ROI）。结果：胶质细胞增生和神经元丢失相关性非常高，彼此在60个ROI。在不存在海绵状状态的情况下，海绵状变化与皮质中的胶质增生和神经元丢失高度相关，但与深部灰质无关。海绵状变化也与皮质和深灰色ROI中的PrPSc负荷显著相关。在深部灰质中，ADC随着海绵状变化（R-2 = 0.78; p < 0.001）和PrPSc负荷（R-2 = 0.51; p = 0.003）的增加而降低。在皮质，ADC下降，增加在所有三个，高度相关的，病理scores.Conclusion：死前减少ADC值，通常发现在Creutzfeldt-Jakob病（CJD）的患者，与海绵状变化尸检。这可以在我们的CJD患者的纹状体和丘脑中清楚地建立，其中海绵状变化的程度与胶质增生或神经元丢失没有显著相关性。神经病学（R）2009; 72：1425-1431
Objective: The cause of hyperintense magnetic resonance changes and reduced apparent diffusion coefficient (ADC) in specific brain regions of patients with Creutzfeldt-Jakob disease (CJD) is unknown. Our aim was to determine the neuropathologic correlates of antemortem water ADC and normalized T2-weighted changes in patients with CJD.Method: Ten patients with CJD and 10 sex- and age-matched healthy controls were studied by DWI and T2-weighted echoplanar MRI. At postmortem, patients with CJD were evaluated for semiquantitative assessment of gliosis and neuronal loss, spongiform changes, and abnormal PrP protein deposition in four cortical regions (occipital, parietal, and temporal cortex, and cingulate gyrus), thalamus, and striatum for a total of 60 regions of interest (ROI).Results: Gliosis and neuronal loss correlated very highly with each other in the 60 ROIs. Where status spongiosus was absent, spongiform change correlated very highly with gliosis and neuronal loss in the cortex, but not in deep gray matter. Spongiform change was also significantly correlated with PrPSc load in both cortical and deep gray ROIs. In deep gray matter, ADC decreased with increasing spongiform change (R-2 = 0.78; p < 0.001) and PrPSc load (R-2 = 0.51; p = 0.003). In the cortex, ADC decreased with increases in all three, highly correlated, pathologic scores.Conclusion: Antemortem reductions in ADC values, typically found in patients with Creutzfeldt-Jakob disease (CJD), are correlated with spongiform changes seen at autopsy. This could be clearly established in the striatum and thalamus of our patients with CJD where the extent of spongiform change was not significantly correlated with gliosis or neuronal loss. Neurology(R) 2009; 72: 1425-1431