Usefulness of perfusion-weighted MR imaging in the differential diagnosis of Alzheimer’s disease and mild cognitive impairment
Anna Zimny, Paweł Szewczyk, Anna Czarnecka, Elżbieta Trypka, Renata Wojtyńska, Jerzy Leszek, Marek Sąsiadek
Med Sci Monit 2010; 16(1): 5-10
Background: Accurate diagnosis of Alzheimer’s disease (AD) and mild cognitive impairment (MCI) is still a clinical problem. The aim of the study was to evaluate the usefulness of perfusion-weighted magnetic resonance (MR) imaging (PWI) and analysis of disturbances in the cerebral microcirculation in the differential diagnosis of AD and MCI.
Material/Methods: Thirty-four patients with AD (mean age, 71.6 years; Mini-Mental State Examination [MMSE] 18), 23 with MCI (mean age, 66.2 years; MMSE, 27), and 15 normal control subjects (mean age, 69 years; MMSE, 29.5) were enrolled in the study. All subjects underwent psychiatric examination and psychological tests. PWI was performed on a 1.5-T MR unit using dynamic susceptibility contrast (DSC) method (IV contrast, 0.3 mM/kg, 5 mL/s). Cerebral blood volume (CBV) measurements relative to cerebellum (rCBV) were assessed in both hippocampi, and temporoparietal and frontal association cortices as well as in the posterior cingulate region.
Results: Significantly lower rCBV values (P<.05) were found in temporoparietal, left frontal, and posterior cingulate cortices in AD patients compared with normal control subjects and in temporoparietal cortices and posterior cingulate region compared with MCI patients. In MCI patients, significantly lower rCBV values were noticed in the left frontal and posterior cingulate cortices compared with normal control subjects.
Conclusions: Our results confirm an important role of cerebral hypoperfusion, particularly in the posterior cingulate region, in the pathogenesis of AD and MCI. Assessment of rCBV, especially in the posterior cingulate cortex, can be useful in the differential diagnosis of AD and MCI.
Keywords: cerebral perfusion, magnetic resonance, Alzheimer’s Disease, mild cognitive impairment, Dementia