[1]林楠楠,曾惠敏.ASL-MRI定量参数与阿尔茨海默病病情程度的关系及其联合诊断效能[J].卒中与神经疾病杂志,2025,32(02):122-127.[doi:10.3969/j.issn.1007-0478.2025.02.004]
　Lin Nannan*,Zeng Huimin..The relationship between ASL-MRI quantitative parameters and the severity of Alzheimer's disease and its combined diagnostic efficacy[J].Stroke and Nervous Diseases,2025,32(02):122-127.[doi:10.3969/j.issn.1007-0478.2025.02.004]
点击复制

ASL-MRI定量参数与阿尔茨海默病病情程度的关系及其联合诊断效能()
分享到：

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第32卷
期数:
2025年02期
页码:
122-127
栏目:
认知功能障碍
出版日期:
2025-04-20

文章信息/Info

Title:
The relationship between ASL-MRI quantitative parameters and the severity of Alzheimer's disease and its combined diagnostic efficacy
文章编号:
1007-0478(2025)02-0122-06
作者:
林楠楠; 曾惠敏
361001 厦门市仙岳医院、医学院附属厦门市仙岳医院、福建省精神医学中心、福建省精神疾病临床医学研究中心(林楠楠); 厦门大学附属第一医院思明分院(曾惠敏)
Author(s):
Lin Nannan*;  Zeng Huimin.
*Xiamen Xianyue Hospital, Xiamen Medical College, Xiamen 361001
关键词:
动脉自旋标记磁共振灌注成像技术 阿尔茨海默病 病情程度 诊断效能
Keywords:
Arterial spin labeling MRI perfusion imaging technique Alzheimer's disease Severity of illness Diagnostic efficacy
分类号:
R742
DOI:
10.3969/j.issn.1007-0478.2025.02.004
文献标志码:
A
摘要:
目的 研究动脉自旋标记磁共振(Arterial spin labeling magnetic resonance imaging,ASL-MRI)灌注成像技术定量参数与阿尔茨海默病病情程度的关系及其联合诊断效能。方法 选取2022年1月-2024年1月于本院就诊的150例阿尔茨海默病患者作为阿尔茨海默病组,100例健康者作为健康对照组,均行ASL-MRI检查,获得ASL-MRI定量参数灰质体积、脑血流量(Cerebral blood flow,CBF)值,比较2组ASL-MRI定量参数灰质体积、CBF值; 根据患者病情程度分为轻度组(n=49)、中度组(n=59)、重度组(n=42),比较3组ASL-MRI定量参数灰质体积、CBF值差异,绘制受试者工作特征(Receiver operating characteristic,ROC)曲线分析ASL-MRI定量参数灰质体积、CBF值诊断阿尔茨海默病病情程度的效能。结果 阿尔茨海默病组ASL-MRI定量参数灰质区、对应受影响区(颞叶、楔前叶、丘脑、前扣带回、后扣带回、内侧前额叶、枕叶、距状裂皮质)的灰质体积、CBF值均低于健康对照组(P<0.05); 随着病情程度的加重,阿尔茨海默病患者ASL-MRI定量参数灰质区、对应受影响区(颞叶、楔前叶、丘脑、前扣带回、后扣带回、内侧前额叶、枕叶、距状裂皮质)的灰质体积、CBF值逐渐降低,即重度组低于中度组,中度组低于轻度组(P<0.05); 以阿尔茨海默病病情程度作为状态变量(轻中度=0,重度=1),以ASL-MRI定量参数灰质体积、CBF值作为检验变量,绘制ROC曲线分析显示以灰质区灰质体积、CBF值诊断阿尔茨海默病病情程度的效能最高,其次为前扣带回灰质体积、CBF值,后扣带回灰质体积、CBF值(P<0.05)。结论 阿尔茨海默病患者灰质体积改变,灰质区域及对应影响区CBF值降低,脑灌注减少,早期通过监测ASL-MRI定量参数变化有助于病情程度的早期诊断。
Abstract:
ObjectiveTo study the relationship between quantitative parameters of Arterial spin labeling magnetic resonance imaging(ASL-MRI)perfusion imaging technology and the severity of Alzheimer's disease, as well as its combined diagnostic efficacy.Methods 150 Alzheimer's disease patients who visited our hospital from January 2022 to January 2024 were selected as the Alzheimer's disease group, and 100 healthy volunteers who underwent physical examination were selected as the healthy control group. ASL-MRI examination was performed to obtain ASL-MRI quantitative parameters of gray matter volume and Cerebral blood flow(CBF). Gray matter volume and CBF of ASL-MRI were compared between the two groups. Patients were divided into mild group(n=49), moderate group(n=59)and severe group(n=42)according to the severity of disease. The differences of ASL-MRI quantitative parameters gray matter volume and CBF value among the three groups were compared, and Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of ASL-MRI quantitative parameters gray matter volume and CBF value in diagnosing the severity of Alzheimer's disease.Results The ASL-MRI quantitative parameters of gray matter area and corresponding affected areas(temporal lobe, anterior cingulate cortex, thalamus, anterior cingulate gyrus, posterior cingulate gyrus, medial prefrontal cortex, occipital lobe)in the Alzheimer's disease group were lower than those in the healthy control group, and the difference was statistically significant(P<0.05). As the severity of the disease worsens, the ASL-MRI quantitative parameters of gray matter area, and the corresponding affected areas(temporal lobe, anterior cingulate cortex, thalamus, anterior cingulate gyrus, posterior cingulate gyrus, medial prefrontal cortex, occipital lobe), and CBF in Alzheimer's disease patients gradually decrease, that is, the severe group is lower than the moderate group, and moderate group is lower than the mild group, and the difference is statistically significant(P<0.05). With the severity of Alzheimer's disease as a state variable(mild to moderate=0, severe=1)and ASL-MRI quantitative parameters gray matter volume and CBF as test variables, ROC curve analysis showed that gray matter volume in the gray matter area and CBF had the highest diagnostic efficiency for Alzheimer's disease severity, followed by gray matter volume in the anterior cingulate gyrus, CBF, and gray matter volume in the posterior cingulate gyrus, CBF(P<0.05).Conclusion Alzheimer's patients have changes in gray matter volume, reduced CBF in gray matter areas and corresponding affected areas, and decreased cerebral perfusion. Early monitoring of ASL-MRI quantitative parameters can help diagnose the severity of the disease.

参考文献/References:

[1] Twarowski B,Herbet M.Inflammatory processes in Alzheimer's disease-pathomechanism,diagnosis and treatment:a review[J].Int J Mol Sci,2023,24(7):6518.
[2] Rostagno AA.Pathogenesis of Alzheimer's disease[J].Int J Mol Sci,2022,24(1):107.
[3] 杨小龙,曹杰,惠辉.动脉自旋标记MRI灌注成像在诊断早老年痴呆患者中的应用[J].神经损伤与功能重建,2020,15(1):17-21.
[4] Monteiro AR,Barbosa DJ,Remião F,et al.Alzheimer's disease:insights and new prospects in disease pathophysiology,biomarkers and disease-modifying drugs[J].Biochem Pharmacol,2023,211(1):115522.
[5] Meng M,Liu F,Ma YL,et al.The identification and cognitive correlation of perfusion patterns measured with arterial spin labeling MRI in Alzheimer's disease[J].Alzheimers Res Ther,2023,15(1):75.
[6] Hertel A,Wenz H,Al-Zghloul M,et al.Crossed cerebellar diaschisis in Alzheimer's disease detected by arterial spin-labelling perfusion MRI[J].In Vivo,2021,35(2):1177-1183.
[7] Zhang L,Xie DF,Li YR,et al.Improving sensitivity of arterial spin labeling perfusion MRI in Alzheimer's disease using transfer learning of deep learning-based ASL denoising[J].J Magn Reson Imaging,2022,55(6):1710-1722.
[8] Kapasouri EM,Ioannidis DC,Cameron D,et al.The utility of arterial spin labeling MRI in medial temporal lobe as a vascular biomarker in Alzheimer's disease spectrum:a systematic review and meta-analysis[J].Diagnostics(Basel),2022,12(12):2967.
[9] Zhu W,Gao Z,Li H,et al.Education reduces cognitive dysfunction in Alzheimer's disease by changing regional cerebral perfusion:an in-vivo arterial spin labeling study[J].Neurol Sci,2023,44(7):2349-2361.
[10] Camargo A,Wang Z,Alzheimer's disease neuroimaging initiative.Longitudinal cerebral blood flow changes in normal aging and the Alzheimer's disease continuum identified by arterial spin labeling MRI[J].J Alzheimers Dis,2021,81(4):1727-1735.
[11] Soman S,Raghavan S,Rajesh PG,et al.Relationship between cerebral perfusion on arterial spin labeling(ASL)MRI with brain volumetry and cognitive performance in mild cognitive impairment and dementia due to Alzheimer's disease[J].Ann Indian Acad Neurol,2021,24(4):559-565.
[12] Ferreira R,Bastos-Leite AJ.Arterial spin labelling magnetic resonance imaging and perfusion patterns in neurocognitive and other mental disorders:a systematic review[J].Neuroradiology,2024,66(7):1065-1081.
[13] Press DZ,Musaeus CS,Zhao L,et al.Levetiracetam increases hippocampal blood flow in Alzheimer's disease as measured by arterial spin labelling MRI[J].J Alzheimers Dis,2023,93(3):939-948.
[14] 王子含,闫少珍,崔碧霄,等.动脉自旋标记成像技术联合认知评分诊断阿尔茨海默病研究[J].中华老年心脑血管病杂志,2022,24(2):171-175.
[15] Mao CH,You H,Hou B,et al.Differentiation of Alzheimer's disease from frontotemporal dementia and mild cognitive impairment based on arterial spin labeling magnetic resonance imaging:a pilot cross-sectional study from PUMCH dementia cohort[J].J Alzheimers Dis,2023,93(2):509-519.
[16] Duan W,Zhou GD,Balachandrasekaran A,et al.Cerebral blood flow predicts conversion of mild cognitive impairment into Alzheimer's disease and cognitive decline:an arterial spin labeling follow-up study[J].J Alzheimers Dis,2021,82(1):293-305.
[17] Chen HR,Xu Y,Chen LL,et al.The convergent and divergent patterns in brain perfusion between Alzheimer's disease and Parkinson's disease with dementia:an ASL MRI study[J].Front Neurosci,2022,16:892374.
[18] Firbank MJ,O'Brien JT,Durcan R,et al.Mild cognitive impairment with Lewy bodies: blood perfusion with arterial spin labelling[J].J Neurol,2021,268(4):1284-1294.
[19] Li JX,Zeng QZ,Luo X,et al.Decoupling of regional cerebral blood flow and brain function along the Alzheimer's disease continuum[J].J Alzheimers Dis,2023,95(1):287-298.
[20] Song Y,Xing H,Zhang ZQ.Microvascular perfusion imaging in Alzheimer's disease[J].J Integr Neurosci,2024,23(4):70.

备注/Memo

备注/Memo:
基金项目:福建医学科技青年培育项目(22FBQN2022128)
更新日期/Last Update: 2025-04-20