T1rho磁共振成像与脑脊液生物标志物在阿尔茨海默病诊断中的应用
T1rho MRI and CSF biomarkers in diagnosis of Alzheimer's disease.
作者信息
Haris Mohammad, Yadav Santosh K, Rizwan Arshi, Singh Anup, Cai Kejia, Kaura Deepak, Wang Ena, Davatzikos Christos, Trojanowski John Q, Melhem Elias R, Marincola Francesco M, Borthakur Arijitt
机构信息
Research Branch, Sidra Medical and Research Center, Doha, Qatar ; Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Research Branch, Sidra Medical and Research Center, Doha, Qatar.
出版信息
Neuroimage Clin. 2015 Feb 26;7:598-604. doi: 10.1016/j.nicl.2015.02.016. eCollection 2015.
In the current study, we have evaluated the performance of magnetic resonance (MR) T1rho (T1ρ) imaging and CSF biomarkers (T-tau, P-tau and Aβ-42) in characterization of Alzheimer's disease (AD) patients from mild cognitive impairment (MCI) and control subjects. With informed consent, AD (n = 27), MCI (n = 17) and control (n = 17) subjects underwent a standardized clinical assessment and brain MRI on a 1.5-T clinical-scanner. T1ρ images were obtained at four different spin-lock pulse duration (10, 20, 30 and 40 ms). T1ρ maps were generated by pixel-wise fitting of signal intensity as a function of the spin-lock pulse duration. T1ρ values from gray matter (GM) and white matter (WM) of medial temporal lobe were calculated. The binary logistic regression using T1ρ and CSF biomarkers as variables was performed to classify each group. T1ρ was able to predict 77.3% controls and 40.0% MCI while CSF biomarkers predicted 81.8% controls and 46.7% MCI. T1ρ and CSF biomarkers in combination predicted 86.4% controls and 66.7% MCI. When comparing controls with AD, T1ρ predicted 68.2% controls and 73.9% AD, while CSF biomarkers predicted 77.3% controls and 78.3% for AD. Combination of T1ρ and CSF biomarkers improved the prediction rate to 81.8% for controls and 82.6% for AD. Similarly, on comparing MCI with AD, T1ρ predicted 35.3% MCI and 81.9% AD, whereas CSF biomarkers predicted 53.3% MCI and 83.0% AD. Collectively CSF biomarkers and T1ρ were able to predict 59.3% MCI and 84.6% AD. On receiver operating characteristic analysis T1ρ showed higher sensitivity while CSF biomarkers showed greater specificity in delineating MCI and AD from controls. No significant correlation between T1ρ and CSF biomarkers, between T1ρ and age, and between CSF biomarkers and age was observed. The combined use of T1ρ and CSF biomarkers have promise to improve the early and specific diagnosis of AD. Furthermore, disease progression form MCI to AD might be easily tracked using these two parameters in combination.
在本研究中，我们评估了磁共振（MR）T1rho（T1ρ）成像和脑脊液生物标志物（总tau蛋白、磷酸化tau蛋白和淀粉样β蛋白42）在区分阿尔茨海默病（AD）患者与轻度认知障碍（MCI）患者及对照受试者方面的性能。在获得知情同意后，AD患者（n = 27）、MCI患者（n = 17）和对照受试者（n = 17）在一台1.5-T临床扫描仪上接受了标准化临床评估和脑部MRI检查。在四个不同的自旋锁定脉冲持续时间（10、20、30和40毫秒）下获取T1ρ图像。通过将信号强度作为自旋锁定脉冲持续时间的函数进行逐像素拟合来生成T1ρ图。计算内侧颞叶灰质（GM）和白质（WM）的T1ρ值。以T1ρ和脑脊液生物标志物作为变量进行二元逻辑回归以对每组进行分类。T1ρ能够预测77.3%的对照受试者和40.0%的MCI患者，而脑脊液生物标志物能够预测81.8% 的对照受试者和46.7%的MCI患者。T1ρ和脑脊液生物标志物联合使用能够预测86.4%的对照受试者和66.7%的MCI患者。在将对照受试者与AD患者进行比较时，T1ρ能够预测68.2%的对照受试者和73.9%的AD患者，而脑脊液生物标志物能够预测77.3%的对照受试者和78.3%的AD患者。T1ρ和脑脊液生物标志物联合使用可将对照受试者的预测率提高到81.8%，将AD患者的预测率提高到82.6%。同样，在将MCI患者与AD患者进行比较时，T1ρ能够预测35.3%的MCI患者和81.9%的AD患者，而脑脊液生物标志物能够预测5；3%的MCI患者和83.0%的AD患者。脑脊液生物标志物和T1ρ共同能够预测59.3%的MCI患者和84.6%的AD患者。在受试者工作特征分析中T1ρ在区分MCI和AD与对照受试者时显示出更高的敏感性，而脑脊液生物标志物显示出更高的特异性。未观察到T1ρ与脑脊液生物标志物之间、T1ρ与年龄之间以及脑脊液生物标志物与年龄之间存在显著相关性。T1ρ和脑脊液生物标志物联合使用有望改善AD的早期和特异性诊断。此外，使用这两个参数联合可能很容易追踪从MCI到AD的疾病进展。
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