High-b-Value Diffusion MR Imaging and Basal Nuclei Apparent Diffusion Coefficient Measurements in Variant and Sporadic Creutzfeldt-Jakob Disease
High-b-Value Diffusion MR Imaging and Basal Nuclei Apparent Diffusion Coefficient Measurements in Variant and Sporadic Creutzfeldt-Jakob Disease
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DOI：
10.3174/ajnr.a1860
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发表时间：
2010-03-01
影响因子：
3.5
通讯作者：
Jaeger, H. R.
中科院分区：
文献类型：
--
作者：
Hyare, H.;Thornton, J.;Jaeger, H. R.
背景和目的：标准b值为1000s/mm(2)的弥散加权成像已成为诊断CJD最敏感的序列。本研究的目的是比较高b值弥散加权成像(b=3000 S/mm(2))和基底核弥散系数测量(b=1000 S/mm(2))对vCJD和sCJD的诊断价值。材料和方法：8例vCJD患者、9例sCJD患者和5名健康志愿者在b=1000 S/mm(2)处进行弥散加权成像，5例vCJD患者、4例sCJD患者和1例生长激素相关CJD患者在b=3000 S/mm(2)处进行弥散加权成像。两位神经放射科顾问对b=1000和b=3000的图像进行了视觉比较。分别测定C、R和DM丘脑ROI在每个b值的平均MR SI和ADC值。结果：在10例患者中，9例b值较高的图像对SI变化更敏感，尤其是在大脑皮质和丘脑，在b=3000时，DM丘脑的SI比更高。对于sCJD患者，在b=1000时，C组和P组的ADC值显著低于对照组(sCJD患者的平均ADC值为587.3+/-84.7 mm(2)/S，对照组为722.7+/-16.6 mm(2)/S，P=0.007)，并且在b=300时，差异更为显著。而在b=1000时，vCJD患者Pu的ADC值升高(平均PuADC=837.6+/-33.0 mm/S(2)，对照组为748.0+/-17.3 mm/S(2)；P<；.001)，但在b=300时无显著意义。结论：b=3000DWI较常规弥散加权成像对病理更敏感。高b值弥散加权成像增加了对人类Pron病的放射学诊断的信心。
BACKGROUND AND PURPOSE: DWI using a standard b-value of 1000s/mm(2) has emerged as the most sensitive sequence for the diagnosis of CJD. The purpose of this study was to investigate whether DWI at a high b-value (b = 3000 s/mm(2)) and ADC measurements in the basal nuclei improve the diagnosis of vCJD and sCJD compared with visual assessment of DWI at a standard b-value (b = 1000 s/mm(2)).MATERIALS AND METHODS: Eight patients with vCJD, 9 patients with sCJD, and 5 healthy volunteers underwent DWI at b = 1000 s/mm(2), and 5 vCJD patients, 4 sCJD patients, and 1 growth hormone-related CJD patient underwent DWI at b = 3000 s/mm(2). Two consultant neuroradiologists performed a visual comparison of the b = 1000 and b = 3000 images. Mean MR SI and ADC values were determined for C, R and DM thalamus ROIs bilaterally at each b-value. SI ratios for each ROI relative to white matter were calculated.RESULTS: In 9 out of 10 patients, the higher b-value images were more sensitive to SI change, particularly in cortex and thalamus, with higher SI ratios at b = 3000 in the DM thalamus. For sCJD at b = 1000, we found significantly lower ADC values in the C and P compared with controls (mean C ADC = 587.3 +/- 84.7 mm(2)/s in sCJD patients versus 722.7 +/- 16.6 mm(2)/s in controls P = .007), and at b = 3000, the differences were more pronounced. In comparison, in vCJD at b = 1000, ADC values were elevated in the Pu (mean Pu ADC = 837.6 +/- 33.0 mm/s(2) in vCJD patients versus 748.0 +/- 17.3 mm/s(2) in controls; P < .001) but failed to reach significance at b = 3000.CONCLUSIONS: Our results demonstrate that b = 3000 DWI, being more sensitive to slowly diffusing tissue water, is more sensitive to pathology in sCJD than is conventional DWI. High-b-value DWI increases confidence in the radiologic diagnosis of human prion disease.