Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI
Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI
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DOI：
10.1212/01.wnl.0000238163.71349.78
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发表时间：
2006-10-10
期刊：
影响因子：
9.9
通讯作者：
Schuff, N.
中科院分区：
文献类型：
--
作者：
Du, A. T.;Jahng, G. H.;Schuff, N.
目的：检测动脉自旋标记（ASL）MRI是否可以检测到额颞叶痴呆（FTD）与认知正常（CN）对照受试者的低灌注模式;确定FTD与阿尔茨海默病（AD）之间的灌注区域差异;并确定FTD中的低灌注是否与认知障碍相关。方法：我们在这项横断面MRI研究中纳入了21例FTD患者、24例AD患者和25例CN受试者。所有受试者均进行MRI扫描，包括T1加权结构图像和ASL-MR图像。结果：与PET和SPECT相似，ASL-MRI检测到FTD患者与CN受试者的右额叶区域灌注不足模式。FTD在顶叶区域和后扣带回的灌注高于AD。FTD的额叶灌注不足与判断和问题解决能力缺陷相关。将额叶灌注添加到灰质（GM）萎缩显著改善了FTD的分类，从正常老化到74%，将顶叶灌注添加到GM萎缩显著改善了FTD的分类，从AD到75%。结合额叶和顶叶灌注进一步将FTD的分类从AD提高到87%。结论：额颞叶痴呆和Alzheimer病在动脉自旋标记MRI上表现出不同的低灌注空间分布。随着研究的深入和评价，动脉自旋标记MRI可能有助于额颞叶痴呆和阿尔茨海默病的鉴别诊断。
Objectives: To test if arterial spin labeling (ASL) MRI could detect a pattern of hypoperfusion in frontotemporal dementia (FTD) vs cognitively normal (CN) control subjects; to determine the regional difference of perfusion between FTD and Alzheimer disease (AD); and to determine whether hypoperfusion in FTD correlates with cognitive impairment. Methods: We included 21 patients with FTD, 24 patients with AD, and 25 CN subjects in this cross-sectional MRI study. All subjects had MRI scans including T1-weighted structural images and ASL-MR images. Results: ASL-MRI detected a pattern of hypoperfusion in right frontal regions in patients with FTD vs CN subjects, similar to PET and SPECT. FTD had higher perfusion than AD in the parietal regions and posterior cingulate. Frontal hypoperfusion in FTD correlated with deficits in judgment and problem solving. Adding frontal perfusion to gray matter (GM) atrophy significantly improved the classification of FTD from normal aging to 74%, and adding parietal perfusion to GM atrophy significantly improved the classification of FTD from AD to 75%. Combining frontal and parietal lobe perfusion further improved the classification of FTD from AD to 87%. Conclusion: Frontotemporal dementia and Alzheimer disease display different spatial distributions of hypoperfusion on arterial spin labeling MRI. With further development and evaluation, arterial spin labeling MRI could contribute to the differential diagnosis between frontotemporal dementia and Alzheimer disease.