Research for Pathophysiology of Diffuse Cerebral White Matter Disease -Evaluation with MRI of Autopsied Brain and Diffusion Weighted MRI-

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1. We performed postmortem MR examinations of 95 brains and compared them to the histology of the whole brain microscopic sections. Diffuse white matter lesions were observed in 12 brains with Alzheimer disease, Binswanger disease, Creutzfeldt-Jakob disease, intravascular lymphomatosis, and Parkinson's disease. While diffuse white matter lesions were observed around the periventricular regions in the Binswanger disease, convolutional white matter and U-fibers were relatively preserved. In the Alzheimer disease, loss of myelinated fibers and gliosis was marked in the temporal subcortical white matter and extreme capsule and was relatively mild in the frontal and parietal subcortical white matter. MR imaging clearly demonstrated such white matter lesions with or without U-fiber involvement observed by histological examination. 2. Diffusion weighted MR imaging was performed in 5 control subjects, 8 patients with Alzheimer's disease (AD) and 8 patients with Binswanger type vascular dementia (VD). Mean values of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated in the genu and splenium of the corpus callosum, anterior and posterior cerebral white matter. There were no statistically significant differences in ADC values of the trace image between the AD and controls in any regions. FA value of the posterior white matter in patients with AD was significantly lower than that of controls. FA value in the patients with VD was significantly lower than that of the AD and controls in any regions. In the VD group, FA value of anterior white matter was lower than that of posterior white matter. The fractional anisotropy may be useful in the differentiation diagnosis of VD from AD.