MR Elastography Demonstrates Unique Regional Brain Stiffness Patterns in Dementias
MR Elastography Demonstrates Unique Regional Brain Stiffness Patterns in Dementias
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DOI：
10.2214/ajr.16.17455
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发表时间：
2017-08-01
影响因子：
5
通讯作者：
Huston, John, III
中科院分区：
文献类型：
--
作者：
ElSheikh, Mona;Arani, Arvin;Huston, John, III
目标。本研究的目的是调查四个痴呆队列（阿尔茨海默病、路易体痴呆、额颞叶痴呆和常压脑积水）中年龄校正脑MR弹性成像（MRE）的发现，并确定其作为痴呆亚型区分生物标志物的潜在用途。研究对象和方法。获得机构审查委员会批准并书面知情同意，对84例受试者进行MRE: 20例正常压力性脑积水患者，8例阿尔茨海默病患者，5例伴路易体痴呆患者，5例额颞叶痴呆患者，46例认知正常对照受试者。使用枕头状被动驱动器将60赫兹振动频率的剪切波传输到大脑中，并在八个不同区域（大脑，额叶，枕叶，顶叶，颞叶，深部灰质-白质，感觉运动皮层和小脑）测定大脑刚度。所有刚度值都经过年龄校正，并与对照组进行比较。采用Wilcoxon秩和检验和线性回归进行统计分析。观察到每个失智症特有的区域僵硬模式。阿尔茨海默病和额颞叶痴呆患者表现出脑僵硬度下降（p = 0.001和p = 0.002分别），额叶和颞叶局部软化。阿尔茨海默病患者还表现出顶叶和感觉运动区软化（p = 0.039和p = 0.018）。正常压力脑积水患者表现为顶叶、枕部和感觉运动区僵硬（p = 0.007、p < 0.001和p < 0.0001）。伴有路易体的痴呆患者在任何区域均未表现出明显的僵硬改变。脑粘弹性结构变化的定量MRE显示了常见痴呆亚型之间独特的区域脑僵硬模式。
OBJECTIVE. The purpose of this study was to investigate age-corrected brain MR elastography (MRE) findings in four dementia cohorts (Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, and normal pressure hydrocephalus) and determine the potential use as a differentiating biomarker in dementia subtypes.SUBJECTS AND METHODS. Institutional review board approval and written informed consent were obtained to perform MRE on 84 subjects: 20 patients with normal pressure hydrocephalus, eight with Alzheimer disease, five with dementia with Lewy bodies, five with frontotemporal dementia, and 46 cognitively normal control subjects. Shear waves of 60-Hz vibration frequency were transmitted into the brain using a pillowlike passive driver, and brain stiffness was determined in eight different regions (cerebrum, frontal, occipital, parietal, temporal, deep gray matter-white matter, sensorimotor cortex, and cerebellum). All stiffness values were age-corrected and compared with control subjects. The Wilcoxon rank sum test and linear regression were used for statistical analysis.RESULTS. Regional stiffness patterns unique to each dementing disorder were observed. Patients with Alzheimer disease and frontotemporal dementia showed decreased cerebral stiffness (p = 0.001 and p = 0.002, respectively) with regional softening of the frontal and temporal lobes. Patients with Alzheimer disease additionally showed parietal lobe and sensorimotor region softening (p = 0.039 and p = 0.018, respectively). Patients with normal pressure hydrocephalus showed stiffening of the parietal, occipital, and sensorimotor regions (p = 0.007, p < 0.001, and p < 0.0001, respectively). Patients with dementia with Lewy bodies did not show significant stiffness changes in any of the regions.CONCLUSION. Quantitative MRE of changes in brain viscoelastic structure shows unique regional brain stiffness patterns between common dementia subtypes.