Dataset Information

T2 Relaxometry and Diffusion Tensor Indices of the Hippocampus and Entorhinal Cortex Improve Sensitivity and Specificity of MRI to Detect Amnestic Mild Cognitive Impairment and Alzheimer's Disease Dementia.

ABSTRACT: BACKGROUND:Quantitative T2 and diffusion MRI indices inform about tissue state and microstructure, both of which may be affected by pathology before tissue atrophy. PURPOSE:To evaluate the capability of both volumetric and quantitative MRI (qMRI) of the hippocampus and entorhinal cortex (EC) for classification of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease dementia (ADD). STUDY TYPE:Retrospective cross-sectional study. POPULATION:Consecutive cohorts of healthy age-matched controls (n?=?62), aMCI patients (n?=?25), and ADD patients (n?=?14). FIELD STRENGTH/SEQUENCE:3T using T1-weighted imaging, T2-weighted imaging, T2 relaxometry and diffusion tensor imaging (DTI). ASSESSMENT:Montreal Cognitive Assessment and paired associate learning tests for cognitive state. Hippocampal subfield volumes by the automated segmentation of hippocampal subfields system from structural brain images. T2 relaxation time and DTI indices quantified for hippocampal subfields. The fraction of voxels with high T2 values (>20 ms above subfield median) was calculated and regionalized for hippocampus and EC. STATISTICAL TESTS:Support vector machine and receiver operating characteristic analyses from cognitive and MRI data. RESULTS:qMRI classified aMCI and ADD with excellent sensitivity (79.0% and 94.5%, respectively) and specificity (85.6% and 86.1%, respectively), superior to volumes alone (70.0% and 84.5% for respective sensitivities; 82.2 and 91.1 for respective specificities) and similar to cognitive tests (61.7% and 87.5% for respective sensitivities; 88.2% and 90.7% for respective specificities). Regions of high T2 are dispersed throughout each hippocampal subfield in aMCI and ADD with higher concentration than controls, and was most pronounced in the EC. No other individual qMRI marker than EC volume can separate aMCI from ADD, however. DATA CONCLUSION: qMRI markers of hippocampal and entorhinal tissue states are sensitive and specific classifiers of aMCI and ADD. They may serve as markers of a neurodegenerative state preceding volume loss. LEVEL OF EVIDENCE:2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:445-455.

SUBMITTER: Knight MJ

PROVIDER: S-EPMC6330085 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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T2 Relaxometry and Diffusion Tensor Indices of the Hippocampus and Entorhinal Cortex Improve Sensitivity and Specificity of MRI to Detect Amnestic Mild Cognitive Impairment and Alzheimer's Disease Dementia.

Knight Michael J MJ Wearn Alfie A Coulthard Elizabeth E Kauppinen Risto A RA

Journal of magnetic resonance imaging : JMRI 20180913 2

<h4>Background</h4>Quantitative T2 and diffusion MRI indices inform about tissue state and microstructure, both of which may be affected by pathology before tissue atrophy.<h4>Purpose</h4>To evaluate the capability of both volumetric and quantitative MRI (qMRI) of the hippocampus and entorhinal cortex (EC) for classification of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease dementia (ADD).<h4>Study type</h4>Retrospective cross-sectional study.<h4>Population</h4>Consecutive coh ...[more]

PMID: 30209854

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Project description:Introduction: Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique that measures the anisotropy of water diffusion. Clinical magnetic resonance imaging scanners enable visualization of the structural integrity of larger axonal bundles in the central nervous system and smaller structures like peripheral nerves; however, their resolution for the depiction of nerve fascicular morphology is limited. Accordingly, high-field strength MRI and strong magnetic field gradients are needed to depict the fascicular pattern. The study aimed to quantify diffusion tensor indices with high-field strength MRI within different anatomical compartments of the median nerve and determine if they correlate with nerve structure at the fascicular level. Methods: Three-dimensional pulsed gradient spin-echo (PGSE) imaging sequence in 19 different gradient directions and b value 1,150 s/mm2 was performed on a 9.4T wide-bore vertical superconducting magnet. Nine-millimeter-long segments of five median nerve samples were obtained from fresh cadavers and acquired in sixteen 0.625 mm thick slices. Each nerve sample had the fascicles, perineurium, and interfascicular epineurium segmented. The diffusion tensor was calculated from the region-average diffusion-weighted signals for all diffusion gradient directions. Subsequently, correlations between diffusion tensor indices of segmentations and nerve structure at the fascicular level (number of fascicles, fascicular ratio, and cross-sectional area of fascicles or nerve) were assessed. The acquired diffusion tensor imaging data was employed for display with trajectories and diffusion ellipsoids. Results: The nerve fascicles proved to be the most anisotropic nerve compartment with fractional anisotropy 0.44 ± 0.05. In the interfascicular epineurium, the diffusion was more prominent in orthogonal directions with fractional anisotropy 0.13 ± 0.02. Diffusion tensor indices within the fascicles and perineurium differed significantly between the subjects (p < 0.0001); however, there were no differences within the interfascicular epineurium (p ≥ 0.37). There were no correlations between diffusion tensor indices and nerve structure at the fascicular level (p ≥ 0.29). Conclusion: High-field strength MRI enabled the depiction of the anisotropic diffusion within the fascicles and perineurium. Diffusion tensor indices of the peripheral nerve did not correlate with nerve structure at the fascicular level. Future studies should investigate the relationship between diffusion tensor indices at the fascicular level and axon- and myelin-related parameters.

Dataset Information

T2 Relaxometry and Diffusion Tensor Indices of the Hippocampus and Entorhinal Cortex Improve Sensitivity and Specificity of MRI to Detect Amnestic Mild Cognitive Impairment and Alzheimer's Disease Dementia.

Publications

T2 Relaxometry and Diffusion Tensor Indices of the Hippocampus and Entorhinal Cortex Improve Sensitivity and Specificity of MRI to Detect Amnestic Mild Cognitive Impairment and Alzheimer's Disease Dementia.

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