动脉自旋标记磁共振成像（ASL-MRI）和氟代脱氧葡萄糖正电子发射断层显像（FDG-PET）在行为变异型额颞叶痴呆（FTD）和阿尔茨海默病（AD）中的诊断效用
Diagnostic utility of ASL-MRI and FDG-PET in the behavioral variant of FTD and AD.
作者信息
Tosun Duygu, Schuff Norbert, Rabinovici Gil D, Ayakta Nagehan, Miller Bruce L, Jagust William, Kramer Joel, Weiner Michael M, Rosen Howard J
机构信息
Department of Radiology and Biomedical Imaging University of California San Francisco California.
Memory and Aging Center Department of Neurology University of California San Francisco California.
出版信息
Ann Clin Transl Neurol. 2016 Aug 30;3(10):740-751. doi: 10.1002/acn3.330. eCollection 2016 Oct.
OBJECTIVE
To compare the values of arterial spin-labeled (ASL) MRI and fluorodeoxyglucose (FDG) PET in the diagnosis of behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD).
METHODS
Partial least squares logistic regression was used to identify voxels with diagnostic value in cerebral blood flow (CBF) and cerebral metabolic rate of glucose (CMRgl) maps from patients with bvFTD ( = 32) and AD ( = 28), who were compared with each other and with cognitively normal controls (CN, = 15). Diagnostic values of these maps were compared with each other.
RESULTS
Regions that differentiated each disorder from controls were similar for CBF and CMRgl. For differentiating AD from CN, the areas under the curve (AUC) for CBF (0.89) and CMRgl (0.91) were similar, with similar sensitivity (CBF: 86%, CMRgl: 78%) and specificity (CBF: 92%, CMRgl: 100%). Likewise, for differentiating bvFTD from CN performances of CBF (AUC = 0.83) and CMRgl (AUC = 0.85) were equivalent, with similar sensitivity (CBF: 78%, CMRgl: 79%) and specificity (CBF: 92%, CMRgl: 100%). In differentiating bvFTD from AD, classification was again similar for CBF (AUC = 0.87) and CMRgl (AUC = 0.79), as were sensitivity (CBF: 83%, CMRgl: 89%) and specificity (CBF: 93%, CMRgl: 78%). None of the differences in any performance measure were statistically significant.
INTERPRETATION
ASL-MRI has similar diagnostic utility as FDG-PET in the diagnosis of AD and bvFTD. Continued development of ASL-MRI as a diagnostic tool for neurodegenerative dementias is warranted.
目的
比较动脉自旋标记（ASL）磁共振成像（MRI）和氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在诊断行为变异型额颞叶痴呆（bvFTD）和阿尔茨海默病（AD）中的价值。
方法
采用偏最小二乘逻辑回归分析，从bvFTD患者（n = 32）和AD患者（n = 28）的脑血流量（CBF）和脑葡萄糖代谢率（CMRgl）图中识别具有诊断价值的体素，并将其相互比较，同时与认知正常对照组（CN，n = 15）进行比较。比较这些图的诊断价值。
结果
CBF和CMRgl将每种疾病与对照组区分开来的区域相似。对于区分AD与CN，CBF（0.89）和CMRgl（0.91）的曲线下面积（AUC）相似，敏感性（CBF：86%，CMRgl：78%）和特异性（CBF：92%，CMRgl：100%）也相似。同样，对于区分bvFTD与CN，CBF（AUC = 0.83）和CMRgl（AUC = 0.85）的表现相当，敏感性（CBF：78%，CMRgl：79%）和特异性（CBF：92%，CMRgl：100%）相似。在区分bvFTD与AD时，CBF（AUC = 0.87）和CMRgl（AUC = 0.79）的分类再次相似，敏感性（CBF：83%，CMRgl：89%）和特异性（CBF：93%，CMRgl：78%）也相似。任何性能指标的差异均无统计学意义。
解读
ASL-MRI在诊断AD和bvFTD方面具有与FDG-PET相似的诊断效用。有必要继续开发ASL-MRI作为神经退行性痴呆的诊断工具。
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