To establish the perfusion pattern of different dementia in Chinese population and evaluate the effectiveness of ASL in differentiating AD from cognitive unimpaired (CU), mild cognitive impairment (MCI), and frontotemporal dementia (FTD).
Four groups of participants were enrolled, including AD, FTD, MCI, and CU based on clinical diagnosis from PUMCH dementia cohort. ASL image was collected using 3D spiral fast spin echo-based pseudo-continuous ASL pulse sequence with background suppression and a high resolution T1-weighted scan covering the whole brain. Data processing was performed using Dr. Brain Platform to get cerebral blood flow (ml/100g/min) in every region of interest cortices.
Participants included 66 AD, 26 FTD, 21 MCI, and 21 CU. Statistically, widespread hypoperfusion neocortices, most significantly in temporal-parietal-occipital cortices, but not hippocampus and subcortical nucleus were found in AD. Hypoperfusion in parietal lobe was most significantly associated with cognitive decline in AD. Hypoperfusion in parietal lobe was found in MCI and extended to adjacent temporal, occipital and posterior cingulate cortices in AD. Significant reduced perfusion in frontal and temporal cortices, including subcortical nucleus and anterior cingulate cortex were found in FTD. Hypoperfusion regions were relatively symmetrical in AD and left predominant especially in FTD.
Specific patterns of ASL hypoperfusion were helpful in differentiating AD from CU, MCI, and FTD.
目的:建立中国人群不同痴呆的灌注模式,并评估ASL在鉴别AD和认知障碍(CU)方面的有效性。轻度认知障碍(MCI),额颞叶痴呆(FTD)。
方法:纳入四组参与者,包括AD,FTD,MCI和CU基于PUMCH痴呆队列的临床诊断。使用具有背景抑制和覆盖整个大脑的高分辨率T1加权扫描的基于3D螺旋快速自旋回波的伪连续ASL脉冲序列收集ASL图像。使用Dr.Brain平台进行数据处理以获得每个感兴趣区域皮质中的脑血流量(ml/100g/min)。
结果:参与者包括66AD,26FTD,21MCI和21CU。统计上,广泛的低灌注新皮质,最显著的是颞叶-顶叶-枕骨皮质,但在AD中未发现海马和皮质下核。顶叶灌注不足与AD的认知功能下降最相关。在MCI中发现顶叶灌注不足,并扩展到相邻的颞叶,AD的枕骨和后扣带回皮质。额叶和颞叶皮质的灌注显著减少,在FTD中发现包括皮质下核和前扣带回皮质。低灌注区域在AD中相对对称,尤其在FTD中占主导地位。
结论:ASL低灌注的特定模式有助于区分AD和CU,MCI和FTD。