脑 MRI 容积测量在比较外伤性脑损伤、阿尔茨海默病和行为变异型额颞叶痴呆中的诊断效用。
Diagnostic utility of brain MRI volumetry in comparing traumatic brain injury, Alzheimer disease and behavioral variant frontotemporal dementia.
机构信息
Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
Department of Neurology, Washington University, St. Louis, MO, USA.
出版信息
BMC Neurol. 2024 Sep 11;24(1):337. doi: 10.1186/s12883-024-03844-4.
BACKGROUND
Brain MRI with volumetric quantification, MRI volumetry, can improve diagnostic delineation of patients with neurocognitive disorders by identifying brain atrophy that may not be evident on visual assessments.
OBJECTIVE
To investigate diagnostic utility of MRI volumetry in traumatic brain injury (TBI), early-onset Alzheimer disease (EOAD), late-onset Alzheimer disease, and behavioral variant frontotemporal dementia (bvFTD).
METHOD
We utilized 137 participants of TBI (n = 40), EOAD (n = 45), LOAD (n = 32), and bvFTD (n = 20). Participants had 3D T1 brain MRI imaging amendable to MRI volumetry. Scan volumes were analyzed with Neuroreader. One-way ANOVA compared brain volumes across diagnostic groups. Discriminant analysis was done with leave-one-out cross validation on Neuroreader metrics to determine diagnostic delineation across groups.
RESULT
LOAD was the oldest compared to other groups (F = 27.5, p < .001). There were no statistically significant differences in sex (p = .58) with women comprising 54.7% of the entire cohort. EOAD and LOAD had the lowest Mini-Mental State Exam (MMSE) scores compared to TBI (p = .04 for EOAD and p = .01 for LOAD). LOAD had lowest hippocampal volumes (Left Hippocampus F = 13.1, Right Hippocampus F = 7.3, p < .001), low white matter volume in TBI (F = 5.9, p < .001), lower left parietal lobe volume in EOAD (F = 9.4, p < .001), and lower total gray matter volume in bvFTD (F = 32.8, p < .001) and caudate atrophy (F = 1737.5, p < .001). Areas under the curve ranged from 92.3 to 100%, sensitivity between 82.2 and 100%, specificity of 78.1-100%. TBI was the most accurately delineated diagnosis. Predictive features included caudate, frontal, parietal, temporal lobar and total white matter volumes.
CONCLUSION
We identified the diagnostic utility of regional volumetric differences across multiple neurocognitive disorders. Brain MRI volumetry is widely available and can be applied in distinguishing these disorders.
背景
通过容积定量的脑 MRI（MRI 容积测量）可以通过识别可能在视觉评估中不明显的脑萎缩来改善神经认知障碍患者的诊断划分。
目的
研究 MRI 容积测量在创伤性脑损伤（TBI）、早发性阿尔茨海默病（EOAD）、迟发性阿尔茨海默病和行为变异额颞叶痴呆（bvFTD）中的诊断效用。
方法
我们使用了 137 名 TBI（n=40）、EOAD（n=45）、LOAD（n=32）和 bvFTD（n=20）参与者的 3D T1 脑 MRI 成像，这些成像可进行 MRI 容积测量。使用 Neuroreader 分析扫描体积。单因素方差分析比较了诊断组之间的脑容量。通过 Neuroreader 指标的留一法交叉验证进行判别分析，以确定组间的诊断划分。
结果
LOAD 组的年龄最大（F=27.5，p<0.001）。各组间的性别无统计学差异（p=0.58），女性占整个队列的 54.7%。与 TBI 相比，EOAD 和 LOAD 的 Mini-Mental State Exam（MMSE）评分最低（EOAD 为 p=0.04，LOAD 为 p=0.01）。LOAD 组的左海马体体积最低（左海马体 F=13.1，右海马体 F=7.3，p<0.001），TBI 组的白质体积最低（F=5.9，p<0.001），EOAD 组的左侧顶叶体积最低（F=9.4，p<0.001），bvFTD 组的总灰质体积最低（F=32.8，p<0.001）和尾状核萎缩（F=1737.5，p<0.001）。曲线下面积范围为 92.3%至 100%，灵敏度为 82.2%至 100%，特异性为 78.1%至 100%。TBI 是最准确的诊断。预测特征包括尾状核、额叶、顶叶、颞叶和总白质体积。
结论
我们确定了跨多种神经认知障碍的区域性容积差异的诊断效用。脑 MRI 容积测量应用广泛，可用于区分这些疾病。
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