National Research Council Canada, Institute for Biodiagnostics (Atlantic), Halifax, Canada.
Alzheimers Dement. 2011 Mar;7(2):185-96. doi: 10.1016/j.jalz.2010.04.004. Epub 2010 Nov 11.
Recent research has demonstrated that brain circulation abnormalities, either during task-induced neural activity or at rest, are more commonly associated with Alzheimer's disease (AD) than was previously thought. This is consistent with the increasing attention to the early involvement of vascular risk factors in the development of AD, in addition to the dominating neurodegenerative pathology. Early detection of cerebral perfusion changes could help advance diagnosis and intervention therapies. The present article reviews advances in perfusion magnetic resonance imaging in the study of AD. In general, there are consistent accounts of cerebral hypoperfusion in the temporal and parietal lobes in people with clinically diagnosed AD. In the early stages of the disease, transient hyperperfusion may occur particularly in the prefrontal cortex, possibly as a compensatory effect. Nevertheless, significant variability in the details of perfusion patterns is present in the early phases, making the use of these methods in early diagnosis difficult. Noninvasive perfusion-weighted magnetic resonance imaging methods have advantages over nuclear medicine imaging, especially for safe usage in long-term follow-up studies. Optimization of perfusion-weighted imaging techniques is crucial for any future clinical application. Additional studies are needed with optimization likely to come with 3T and higher field strength magnets.
最近的研究表明，大脑循环异常，无论是在任务诱导的神经活动期间还是在休息时，与阿尔茨海默病（AD）的相关性比以前认为的更为常见。这与越来越关注血管危险因素在 AD 发展中的早期参与，除了主导的神经退行性病理之外，是一致的。早期发现脑灌注变化有助于推进诊断和干预治疗。本文综述了灌注磁共振成像在 AD 研究中的进展。一般来说，在临床诊断为 AD 的患者中，颞叶和顶叶存在一致的脑灌注不足的描述。在疾病的早期阶段，特别是在前额叶皮质可能会出现短暂的高灌注，可能是一种代偿效应。然而，在早期阶段，灌注模式的细节存在很大的可变性，使得这些方法难以用于早期诊断。与核医学成像相比，非侵入性灌注加权磁共振成像方法具有优势，尤其是在长期随访研究中的安全使用方面。优化灌注加权成像技术对于任何未来的临床应用都至关重要。需要进行更多的研究，可能需要 3T 及更高场强的磁铁来进行优化。
