Mild Cognitive Impairment: Baseline and Longitudinal Structural MR Imaging Measures Improve Predictive Prognosis
Mild Cognitive Impairment: Baseline and Longitudinal Structural MR Imaging Measures Improve Predictive Prognosis
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DOI：
10.1148/radiol.11101975
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发表时间：
2011-06-01
期刊：
影响因子：
19.7
通讯作者：
Dale, Anders M.
中科院分区：
文献类型：
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作者：
McEvoy, Linda K.;Holland, Dominic;Dale, Anders M.
目的：为了评估是否单时间点和纵向容积磁共振（MR）成像的措施，健忘型轻度认知功能障碍（MCI）的患者提供预测预后的信息。材料和方法：本研究进行了机构审查委员会的批准，并符合健康保险责任法案的规定。从所有参与者或参与者的法律的监护人处获得书面知情同意书。对164例阿尔茨海默病（AD）患者和203例健康对照者进行了磁共振成像指标的交叉验证判别分析。通过使用在一个时间点获得的MR图像数据或通过将单个时间点测量与1年变化测量相结合进行单独分析。将所得判别函数应用于317例MCI病例，以获得个体患者风险评分。转换为AD的风险估计为风险评分百分位数的连续函数。计算风险评分四分位数的Kaplan-Meier生存曲线。转换为AD的比值比（OR）之间的最高和最低的四分位scores.Results计算：从基线MR检查的个体化风险估计表明，1年的风险转换为AD的范围从3%到40%（平均组风险，17%; OR，7.2最高与最低分数的四分位数）。包括全球和区域数量的1年变化的措施显著改善了风险估计（P = 0.01），随后一年转换为AD的风险范围为3%至69%（平均组风险为27%;最高与最低得分四分位数的OR为12.0）。相对于仅由MCI的临床诊断所赋予的转换为AD的风险，MR成像测量产生实质上更多信息的患者特异性风险估计。这种预测预后信息将是至关重要的，如果疾病修饰疗法变得可用。(C)RSNA，2011年
Purpose: To assess whether single-time-point and longitudinal volumetric magnetic resonance (MR) imaging measures provide predictive prognostic information in patients with amnestic mild cognitive impairment (MCI).Materials and Methods: This study was conducted with institutional review board approval and in compliance with HIPAA regulations. Written informed consent was obtained from all participants or the participants' legal guardians. Cross-validated discriminant analyses of MR imaging measures were performed to differentiate 164 Alzheimer disease (AD) cases from 203 healthy control cases. Separate analyses were performed by using data from MR images obtained at one time point or by combining single-time-point measures with 1-year change measures. Resulting discriminant functions were applied to 317 MCI cases to derive individual patient risk scores. Risk of conversion to AD was estimated as a continuous function of risk score percentile. Kaplan-Meier survival curves were computed for risk score quartiles. Odds ratios (ORs) for the conversion to AD were computed between the highest and lowest quartile scores.Results: Individualized risk estimates from baseline MR examinations indicated that the 1-year risk of conversion to AD ranged from 3% to 40% (average group risk, 17%; OR, 7.2 for highest vs lowest score quartiles). Including measures of 1-year change in global and regional volumes significantly improved risk estimates (P = 001), with the risk of conversion to AD in the subsequent year ranging from 3% to 69% (average group risk, 27%; OR, 12.0 for highest vs lowest score quartiles).Conclusion: Relative to the risk of conversion to AD conferred by the clinical diagnosis of MCI alone, MR imaging measures yield substantially more informative patient-specific risk estimates. Such predictive prognostic information will be critical if disease-modifying therapies become available. (C) RSNA, 2011