Schuff N, Amend D L, Meyerhoff D J, Tanabe J L, Norman D, Fein G, Weiner M W
Magnetic Resonance Unit, Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
Radiology. 1998 Apr;207(1):91-102. doi: 10.1148/radiology.207.1.9530304.
To replicate previous hydrogen-1 magnetic resonance (MR) spectroscopic imaging findings of metabolic abnormalities in patients with Alzheimer disease (AD), to verify that metabolic abnormalities are not an artifact of structural variations measured at MR imaging, to determine whether metabolic changes correlate with dementia severity, and to test whether MR imaging and MR spectroscopic imaging findings together improve ability to differentiate AD.
MR spectroscopic imaging and MR imaging were performed in 28 patients with AD and 22 healthy elderly subjects. Spectroscopic imaging data were coregistered with MR imaging segmentation data to obtain volume-corrected metabolite concentrations.
Consistent with previous results, N-acetyl aspartate (NAA) levels were statistically significantly reduced in frontal and posterior mesial cortex of AD patients, presumably due to neuronal loss. NAA level reductions were independent of structural variations measured at MR imaging and, in parietal mesial cortex, were correlated mildly with dementia severity. Spectroscopic imaging findings of NAA level combined with MR imaging measures did not improve discrimination power for AD relative to that of MR imaging alone.
Reduced NAA levels in frontoparietal brain are of limited use for diagnosis of AD. However, they are not an artifact of structural variations and thus may provide useful information for the understanding of the pathologic processes underlying AD.
重复先前关于阿尔茨海默病(AD)患者代谢异常的氢-1磁共振(MR)波谱成像研究结果,验证代谢异常并非MR成像所测量的结构变异的伪影,确定代谢变化是否与痴呆严重程度相关,并测试MR成像和MR波谱成像结果联合起来是否能提高鉴别AD的能力。
对28例AD患者和22名健康老年受试者进行了MR波谱成像和MR成像。将波谱成像数据与MR成像分割数据进行配准,以获得体积校正后的代谢物浓度。
与先前结果一致,AD患者额叶和后内侧皮质中的N-乙酰天门冬氨酸(NAA)水平在统计学上显著降低,推测是由于神经元丢失所致。NAA水平降低与MR成像所测量的结构变异无关,且在顶叶内侧皮质中,与痴呆严重程度呈轻度相关。NAA水平的波谱成像结果与MR成像测量结果联合起来,相对于单独使用MR成像,并未提高对AD的鉴别能力。
额顶叶脑区NAA水平降低对AD诊断的作用有限。然而,它们并非结构变异的伪影,因此可能为理解AD潜在的病理过程提供有用信息。