Hanyu H, Imon Y, Sakurai H, Iwamoto T, Takasaki M, Shindo H, Kakizaki D, Abe K
Department of Geriatric Medicine, Tokyo Medical College, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Eur J Neurol. 1999 Mar;6(2):195-203. doi: 10.1111/j.1468-1331.1999.tb00013.x.
We investigated changes in water diffusion in the cerebral white matter of 14 patients with vascular dementia of the Binswanger type (VDBT) and ten patients with Alzheimer's disease (AD) with periventricular hyperintensity (PVH) lesions using diffusion-weighted magnetic resonance imaging (MRI) and studied the pathophysiological differences between white matter lesions found in these two conditions. Apparent diffusion coefficients (ADCs) in the anterior and posterior white matter and the genu and splenium of the corpus callosum were significantly higher in both groups of patients than in the 12 age-matched controls, and ADC values in VDBT and AD groups were almost the same. ADC ratios, defined as diffusion restricted perpendicular to the direction of nerve fibers, were also significantly higher in the patients than in the control subjects. However, there were regional differences in ADC ratios in the two conditions, with ratios in VDBT being higher in the anterior portions of the white matter but ratios in AD were higher in the posterior portions. The diffusion-weighted MRI technique may be useful in the differential diagnosis of VDBT and AD with white matter lesions.
我们使用扩散加权磁共振成像（MRI）研究了14例宾斯旺格型血管性痴呆（VDBT）患者和10例伴有脑室周围高信号（PVH）病变的阿尔茨海默病（AD）患者脑白质中水分子扩散的变化，并研究了这两种情况下发现的白质病变之间的病理生理差异。两组患者前、后白质以及胼胝体膝部和压部的表观扩散系数（ADC）均显著高于12名年龄匹配的对照组，且VDBT组和AD组的ADC值几乎相同。定义为垂直于神经纤维方向扩散受限的ADC比率在患者中也显著高于对照组。然而，两种情况下ADC比率存在区域差异，VDBT患者白质前部的比率较高，而AD患者后部的比率较高。扩散加权MRI技术可能有助于VDBT和伴有白质病变的AD的鉴别诊断。
