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White Matter Damage in Alzheimer Disease and Mild Cognitive Impairment: Assessment with Diffusion-Tensor MR Imaging and Parallel Imaging Techniques¹

¹ From the Department of Clinical Radiology, University Hospitals–Grosshadern (R.S., O.D., M.F.R., S.O.S.); and Department of Psychiatry (S.J.T., H.H.), Ludwig Maximilians University of Munich, Marchioninistrasse 15, 81377 Munich, Germany. From the 2004 RSNA Annual Meeting. Received October 20, 2005; revision requested December 15; revision received June 8, 2006; accepted July 7; final version accepted September 1. Address correspondence to R.S. (e-mail: Robert.Stahl{at}med.uni-muenchen.de).

Purpose: To prospectively determine regional differences in fiber tract integrity between elderly patients with Alzheimer disease (AD), those with mild cognitive impairment (MCI), and healthy elderly subjects by using diffusion-tensor imaging with parallel imaging techniques and a new eight-element receiving coil.

Materials and Methods: Institutional review board approval and informed consent were obtained. Fifteen patients with AD (seven men, eight women; mean age; 68.8 years), 16 patients with MCI (nine men, seven women; mean age, 68.9 years) and 19 healthy control subjects (eight men, 11 women; mean age, 63.9 years) underwent diffusion-tensor imaging performed with a 1.5-T magnetic resonance system. An echo-planar imaging diffusion sequence was used with an integrated parallel acquisition technique (PAT) and an eight-element head coil. The mean apparent diffusion coefficient (ADC), fractional anisotropy (FA), and relative anisotropy (RA) values of several white matter (WM) regions were determined. The Kruskal-Wallis test was used initially to test for overall equality of median values in each data group. Single posttest comparisons were performed with the Mann-Whitney U test, with an overall statistical significance level of .05.

Results: FA and RA values were significantly (P < .05) decreased, whereas ADC values in the splenium of the corpus callosum were higher in patients with AD than in patients with MCI. Evidence of higher ADC values in the WM of the temporal lobe was observed in patients with AD compared with the ADC values in patients with MCI and in control subjects. ADC values in the parietal WM were significantly (P < .05) elevated in patients with MCI compared with those in control subjects. The images obtained with integrated PAT showed fewer susceptibility artifacts and were less distorted than images acquired without parallel imaging techniques.

Conclusion: Reduced FA and RA values in patients with AD suggest that diffusion-tensor imaging of the brain can be used to confirm clinical manifestation of AD but is less applicable in the detection of MCI.

© RSNA, 2007

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