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MR-Volumetrie zur Darstellung von Verteilung und zeitlicher Abfolge neokortikaler Degeneration bei Morbus Alzheimer

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Zusammenfassung

Fragestellung

Volumetrische Analyse des Corpus callosum und Hippokampus mittels MRT bei der Alzheimer-Erkrankung (AD), mit dem Ziel die regionale Verteilung und Progression der neokortikalen relativ zur allokortikalen Neurodegeneration zu erfassen.

Methodik

In mehreren Studienabschnitten wurden Patienten mit AD und gesunde Kontrollen untersucht. Als Grundlage für die Volumetrie diente eine sagittale 3D-T1w–Gradientenechosequenz. Die Vermessung des Corpus callosum (CC) erfolgte in der mittsagittalen Schicht, wobei 5 Subregionen definiert wurden. Die Volumetrie des Hippokampus-Amygdala-Komplexes (HAK) wurde durch Segmentierung an koronar reorientierten Schichten durchgeführt.

Ergebnisse

Bei Patienten mit AD fand sich eine signifikante Atrophie in Rostrum und Splenium des CC. Dabei zeigte sich eine Korrelation der Atrophie mit dem Schweregrad der Demenz, jedoch nicht mit dem Ausmaß von Marklagerläsionen. Im Vergleich mit der 18FDG-PET fand sich eine signifikante Korrelation zwischen dem Muster der CC-Atrophie und dem regionalen Glukosemetabolismus. Eine ROC-Analyse zeigte sogar in frühen Stadien der Erkrankung keinen signifikanten Unterschied für die diagnostische Genauigkeit der Volumina von HAK und Region C5 (Splenium) des CC.

Schlussfolgerungen

Die regionale Atrophie des CC kann bereits in frühen Demenzstadien zur Beurteilung von Ausmaß und Verteilung einer neokortikalen Neurodegeneration eingesetzt werden.

Abstract

Purpose

Volumetric analysis of the corpus callosum and hippocampus using MRI in Alzheimer's disease (AD) to evaluate the regional pattern and progression of neocortical neurodegeneration.

Methods

In subsequent studies we investigated patients with AD and healthy controls. Volumetry was based on MRI-data from a sagittal 3D T1w-gradient echo sequence. The corpus callosum (CC) was measured in a midsagittal slice, and subdivided into 5 subregions. Volumetry of the hippocampus/amygdala-formation (HAF) was performed by segmentation in coronary reoriented slices.

Results

In AD patients we found a significant atrophy in the rostrum und splenium of CC. The atrophy was correlated with the severity of dementia, but no correlation was found with the load of white matter lesions. In comparison with 18FDG-PET, we found a significant correlation of regional CC-atrophy with the regional decline of cortical glucose metabolism. A ROC-analysis demonstrated no significant differences in the diagostic accuracy of HAF volumetry and regional CC volumetry of the splenium (region C5) even in mild stages of dementia.

Conclusion

Regional atrophy of CC can be used as a marker of neocortical degeneration even in early stages of dementia in AD.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, München

    G. Leinsinger, A. Wismüller, C. Born, T. Meindl, W. Flatz, S. Schönberg & M. Reiser

  2. Klinik für Psychiatrie, Ludwig-Maximilians-Universität München, München

    S. Teipel, J. Pruessner & H. Hampel

  3. Institut für Klinische Radiologie, LMU München, Ziemssenstraße 1, 80336 , München

    G. Leinsinger

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  1. G. Leinsinger
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  2. S. Teipel
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  3. A. Wismüller
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  4. C. Born
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  9. H. Hampel
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  10. M. Reiser
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Correspondence to G. Leinsinger.

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Leinsinger, G., Teipel, S., Wismüller, A. et al. MR-Volumetrie zur Darstellung von Verteilung und zeitlicher Abfolge neokortikaler Degeneration bei Morbus Alzheimer. Radiologe 43, 537–542 (2003). https://doi.org/10.1007/s00117-003-0928-1

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  • DOI: https://doi.org/10.1007/s00117-003-0928-1

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