Fully-automated volumetric MRI with normative ranges: translation to clinical practice.
Fully-automated volumetric MRI with normative ranges: translation to clinical practice.
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DOI：
10.3233/ben-2009-0226
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发表时间：
2009
影响因子：
2.8
通讯作者：
Brewer JB
中科院分区：
文献类型：
--
作者：
Brewer JB
神经退行性疾病，如阿尔茨海默病（AD），与大脑中神经病理学传播的特征模式有关。疾病进展通常伴有区域萎缩，这种萎缩可使用结构磁共振成像（MRI）进行无创检测。大量数据已证明对阿尔茨海默病区域萎缩进行定量测量的价值，表明体积磁共振成像（vMRI）可能是一种有用的临床工具。vMRI为认知障碍患者的神经退行性疾病提供了生物学证据。然而，有几个障碍阻碍了vMRI在临床实践中的应用。这些障碍包括缺乏标准化的MRI采集方案、MRI数据的空间扭曲、易受操作者间差异影响的劳动密集型vMRI方法、缺乏体积测量的正常范围以及难以将vMRI整合到临床工作流程中。脑成像的多机构研究，如阿尔茨海默病神经影像学倡议（ADNI），推动了vMRI的进展，并有助于应对这些挑战。新的全自动脑结构体积测量方法，加上使用标准化MRI方案的大型多中心研究，现在使得能够为vMRI制定年龄调整后的正常范围。这些进展对于为医生提供一个评估患者大脑区域萎缩模式和程度以及在临床实践中应用vMRI的框架至关重要。
Neurodegenerative disorders, such as Alzheimer’s disease (AD), are associated with characteristic patterns of neuropathological spread in the brain. Disease progression is usually accompanied by regional atrophy that can be detected noninvasively using structural magnetic resonance imaging (MRI). A wealth of data has demonstrated the value of quantitative measurements of regional atrophy in AD, suggesting that volumetric MRI (vMRI) may be a useful clinical tool. vMRI provides biological evidence of neurodegenerative disease in patients with cognitive impairment. However, several hurdles impede implementation of vMRI in clinical practice. These include a lack of standardized MRI acquisition protocols, spatial distortions in MRI data, labor-intensive vMRI methods susceptible to interoperator variability, a lack of normative ranges for volume measures, and difficulty integrating vMRI in clinical workflow. Advances in vMRI have resulted from multi-institutional studies of brain imaging, such as the Alzheimer’s Disease Neuroimaging Initiative (ADNI), and help address these challenges. New, fully-automated measures of brain structure volumes coupled with large, multi-center studies using standardized MRI protocols now allow the development of age-adjusted normative ranges for vMRI. Such advances are critical for providing physicians a framework for assessing the pattern and degree of regional atrophy in a patient's brain and applying vMRI in clinical practice.