Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD
Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD
复制标题
DOI：
10.1212/wnl.54.9.1760
复制
发表时间：
2000-05-09
期刊：
影响因子：
9.9
通讯作者：
Petersen, RC
中科院分区：
文献类型：
--
作者：
Xu, Y;Jack, CR;Petersen, RC
目的：基于mri的海马萎缩测量是阿尔茨海默病中内侧颞叶早期病理变性的敏感指标。然而，阿尔茨海默病病理首先出现在鼻内/内嗅皮层，而不是海马体。作者检验了这样一个假设：在三个临床组中，基于核磁共振的内嗅皮层测量比海马体积测量更敏感；对照组、轻度认知障碍（MCI）患者和轻度可能的AD患者。方法：作者研究了30名对照组、30名轻度认知障碍患者和30名AD患者，这些患者在年龄、性别和教育程度上与临床组相匹配。所有人都接受了标准化的MRI检查，作者据此测量了海马体积、内嗅皮质体积和内嗅皮质内侧边界的累积长度。结果：除了内嗅皮层的累积长度外，所有MRI测量结果均存在组间两两差异（p < 0.01），这并不能区分对照组和MCI患者。虽然海马和内嗅皮质体积测量比内嗅距离测量提供了稍好的组间区分，但三种MRI测量之间的区分能力总体差异很小。结论：尽管理论上认为早期AD的内嗅测量具有优势，但作者发现海马和内嗅皮层的MRI测量在组间辨别上大致相等。海马的测量可能是可取的，因为MRI对内嗅皮层边界的描述可能被解剖学模糊、图像伪影或两者所掩盖。
Objective: MRI-based measurements of hippocampal atrophy are a sensitive indicator of the early pathologic degeneration of the medial temporal lobe in AD. However, AD pathology appears first in the transentorhinal/ entorhinal cortex, not the hippocampus. The authors tested the hypothesis that MRI-based measurements of the entorhinal cortex are more sensitive than measurements of hippocampal volume in discriminating among three clinical groups; controls, patients with a mild cognitive impairment (MCI), and patients with mild probable AD. Methods: The authors studied 30 controls, 30 patients with MCI, and 30 patients with AD who were matched among clinical groups on age, gender, and education. All underwent a standardized MRI protocol from which the authors made measurements of hippocampal volume, entorhinal cortex volume, and the cumulative length of the medial border of the entorhinal cortex. Results: Pairwise intergroup differences (p < 0.01) were found for all MRI measurements with the exception of the cumulative length of the entorhinal cortex, which did not differentiate controls from MCI patients. Whereas the hippocampal and entorhinal cortex volume measurements provided slightly better intergroup discrimination than the entorhinal distance measurement, overall differences in discriminating ability among the three MRI measurements were minor. Conclusions: Despite the theoretical rationale for the superiority of entorhinal measurements in early AD, the authors found MRI measurements of the hippocampus and entorhinal cortex were approximately equivalent at intergroup discrimination. Measurements of the hippocampus may be preferable because MRI depiction of the boundaries of the entorhinal cortex can be obscured by anatomic ambiguity, image artifact, or both.