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[用于评估阿尔茨海默病新皮质变性的区域模式和进展的容积磁共振成像]

[Volumetric MRI for evaluation of regional pattern and progressin of neocortical degeneration in Alzheimer's disease].

作者信息

Leinsinger G, Teipel S, Wismüller A, Born C, Meindl T, Flatz W, Schönberg S, Pruessner J, Hampel H, Reiser M

机构信息

Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Munich.

出版信息

Radiologe. 2003 Jul;43(7):537-42. doi: 10.1007/s00117-003-0928-1.

Abstract

PURPOSE

Volumetric analysis of the corpus callosum and hippocampus using MRI in Alzheimer's disease (AD) to evaluate the regional pattern and progression of neocortical neurodegeneration.

METHODS

In subsequent studies we investigated patients with AD and healthy controls. Volumetry was based on MRI-data from a sagittal 3D T1w-gradient echo sequence. The corpus callosum (CC) was measured in a midsagittal slice, and subdivided into 5 subregions. Volumetry of the hippocampus/amygdala-formation (HAF) was performed by segmentation in coronary reoriented slices.

RESULTS

In AD patients we found a significant atrophy in the rostrum und splenium of CC. The atrophy was correlated with the severity of dementia, but no correlation was found with the load of white matter lesions. In comparison with (18)FDG-PET, we found a significant correlation of regional CC-atrophy with the regional decline of cortical glucose metabolism. A ROC-analysis demonstrated no significant differences in the diagnostic accuracy of HAF volumetry and regional CC volumetry of the splenium (region C5) even in mild stages of dementia.

CONCLUSION

Regional atrophy of CC can be used as a marker of neocortical degeneration even in early stages of dementia in AD.

摘要

目的

利用磁共振成像(MRI)对阿尔茨海默病(AD)患者的胼胝体和海马体进行容积分析,以评估新皮质神经退行性变的区域模式和进展情况。

方法

在后续研究中,我们调查了AD患者和健康对照者。容积测量基于矢状面三维T1加权梯度回波序列的MRI数据。在正中矢状面切片上测量胼胝体(CC),并将其细分为5个亚区域。通过在冠状面重定位切片上进行分割来测量海马体/杏仁核结构(HAF)的容积。

结果

在AD患者中,我们发现CC的嘴部和压部存在明显萎缩。这种萎缩与痴呆的严重程度相关,但与白质病变的负荷无关。与(18)氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)相比,我们发现CC区域萎缩与皮质葡萄糖代谢的区域下降存在显著相关性。一项ROC分析表明,即使在痴呆的轻度阶段,HAF容积测量和压部(C5区)的CC区域容积测量的诊断准确性也没有显著差异。

结论

即使在AD痴呆的早期阶段,CC的区域萎缩也可作为新皮质变性的标志物。

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