Detection of Neuronal Loss in Alzheimer Disease Using Magnetization Transfer MR Imaging

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Purpose: To evaluate changes related to the neuronal loss of the hippocampus and the entorhinal cortex in patients with early Alzheimer disease (AD) using high-resolution magnetization-transfer (MT) fast spin-echo (FSE), and fast short inversion-time inversion-recovery (FSTIR) techniques. Methods: Fifteen patients with AD including early stages and ten age-matched normal volunteers were prospectively examined by a 1.5 Tesla superconductive MR scanner (Signal Horizon Lx, GEMS). The pulse sequences we used were FSTIR 4000/120/36 (TR/Tl/Teff) sequence with original optimizations, and proton-density weighted (PDW) FSE 1000/24 (TR/Teeff) sequence with single and multislice acquisitions. In each case, 4 mm thick coronal images through mamillary bodies were obtained with a 17cm field of view and zero-interpolated 512x512 matrices. Signal intensities of the hippocampus, entorhinal cortex, cingulate gyrus, superior temporal gyrus, caudate nucleus, deep white matter, and CSF were measured in sin … More gle-slice and multislice PDW-FSE images. Measurement areas were manually determined on FSTIR images in which gray/white matter contrast was remarkable. The MT ratio (MTR) in each structure was calculated from signal intensities obtained on single/multislice PDW-FSE images, and was normalized by MTR in the caudate nucleus.Results: In all of the cases, measurement areas were readily determined with guidance of FSTIR images. MTRs of the hippocampus and the entorhinal cortex in patients with AD were lower than the control group with statistical significance, whereas those of the other structures indicated no significant alterations.Conclusion: We successfully measured MTRs of the hippocampus and the entorhinal cortex by a combination of single/multislice PDW-FSE and optimized FSTIR techniques. MTRs in the hippocampus and the entorhinal cortex were decreased in early AD, suggesting changes related to the neuronal loss. MT measurements using high-resolution FSE/FSTIR images may help early diagnosis of AD before visible atrophy occurs. Less