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

目的：采用高分辨率磁化传递（MT）、快速自旋回波（FSE）和快速短反转时间反转恢复（FSTIR）技术评价早期阿尔茨海默病（AD）患者海马和内嗅皮层神经元丢失的相关变化。研究方法：15例AD患者（包括早期阶段）和10名年龄匹配的正常志愿者采用1.5T的MRI扫描仪（Signal Horizon Lx，GEMS）进行前瞻性检查。我们使用的脉冲序列是具有原始优化的FSTIR 4000/120/36（TR/Tl/Teff）序列和具有单层和多层采集的质子密度加权（PDW）FSE 1000/24（TR/Teeff）序列。在每种情况下，通过乳头体获得4 mm厚的冠状面图像，视野为17 cm，零插值512 x512矩阵。海马、内嗅皮层、扣带回、上级颞回、尾状核、深部白色物质和脑脊液的信号强度在正弦信号下测量。 ...更多信息 切片和多层PDW-FSE图像。在FSTIR图像上手动确定测量区域，其中灰/白色物质对比显著。MT比率（MTR）在每个结构中的信号强度计算单/multislice PDW-FSE图像上获得的，并通过MTR在尾状核。结果：在所有的情况下，测量区域很容易确定与FSTIR图像的指导下进行归一化。AD患者海马和内嗅皮层的MTRs均低于对照组，具有统计学意义，而其他结构的MTRs则无显著性改变。结论：我们成功地测量了海马和内嗅皮层的MTRs的单/多层PDW-FSE和优化的FSTIR技术相结合。AD早期海马和内嗅皮层的MTRs减少，提示与神经元丢失有关的变化。使用高分辨率FSE/FSTIR图像进行MT测量可能有助于在可见萎缩发生之前早期诊断AD。少

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