Binnewijzend Maja A A, Kuijer Joost P A, van der Flier Wiesje M, Benedictus Marije R, Möller Christiane M, Pijnenburg Yolande A L, Lemstra Afina W, Prins Niels D, Wattjes Mike P, van Berckel Bart N M, Scheltens Philip, Barkhof Frederik
Department of Radiology and Nuclear Medicine, VU University Medical Center and Neuroscience Campus Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands,
Eur Radiol. 2014 Sep;24(9):2326-33. doi: 10.1007/s00330-014-3172-3. Epub 2014 Jul 5.
To compare pseudo-continuous arterial spin-labelled (PCASL) magnetic resonance imaging (MRI) measured quantitative cerebral blood flow (CBF) of patients with frontotemporal dementia (FTD), dementia with Lewy Bodies (DLB), Alzheimer's disease (AD) and controls, in a region of interest (ROI) and voxel-wise fashion.
We analysed whole-brain 3D fast-spin-echo PCASL images of 20 FTD patients, 14 DLB patients, 48 AD patients and 50 controls from the Amsterdam Dementia Cohort. Regional CBF patterns were compared using analyses of variance for repeated measures. Permutation tests were used for voxel-wise comparisons. Analyses were performed using uncorrected and partial volume corrected (PVC) maps. All analyses were corrected for age and sex.
There was an interaction between diagnosis and region (p < 0.001), implying differences in regional CBF changes between diagnostic groups. In AD patients, CBF was decreased in all supratentorial regions, most prominently so in the posterior regions. DLB patients showed lowest CBF values throughout the brain, but temporal CBF was preserved. Supratentorial PVC cortical CBF values were lowest in the frontal lobes in FTD patients, and in the temporal lobes in AD patients.
Patients with AD, FTD and DLB display distinct patterns of quantitative regional CBF changes. 3D-PCASL may provide additional value in the workup of dementia patients.
Patterns of regional CBF changes differ between AD, FTD and DLB patients. CBF is lower throughout the brain in DLB than AD and FTD. 3D-PCASL MRI is a potential non-invasive and easily accessible alternative to FDG-PET. 3D-PCASL MRI may be of additional value in the workup of dementia.
以感兴趣区域（ROI）和体素方式比较额颞叶痴呆（FTD）、路易体痴呆（DLB）、阿尔茨海默病（AD）患者及对照组的伪连续动脉自旋标记（PCASL）磁共振成像（MRI）测量的定量脑血流量（CBF）。
我们分析了来自阿姆斯特丹痴呆队列的20例FTD患者、14例DLB患者、48例AD患者和50例对照的全脑三维快速自旋回波PCASL图像。使用重复测量方差分析比较区域CBF模式。置换检验用于体素水平比较。分析使用未校正和部分容积校正（PVC）图谱进行。所有分析均校正了年龄和性别。
诊断与区域之间存在交互作用（p < 0.001），这意味着诊断组之间区域CBF变化存在差异。在AD患者中，所有幕上区域的CBF均降低，后颅区域最为明显。DLB患者全脑CBF值最低，但颞叶CBF得以保留。FTD患者幕上PVC皮质CBF值在额叶最低，AD患者在颞叶最低。
AD、FTD和DLB患者表现出不同的定量区域CBF变化模式。三维PCASL可能在痴呆患者的检查中提供额外价值。
AD、FTD和DLB患者区域CBF变化模式不同。DLB患者全脑CBF低于AD和FTD患者。三维PCASL MRI是FDG-PET潜在的非侵入性且易于获取的替代方法。三维PCASL MRI在痴呆检查中可能具有额外价值。
