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The value of whole-brain CT perfusion imaging and CT angiography using a 320-slice CT scanner in the diagnosis of MCI and AD patients

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Abstract

Objectives

To validate the value of whole-brain computed tomography perfusion (CTP) and CT angiography (CTA) in the diagnosis of mild cognitive impairment (MCI) and Alzheimerʼs disease (AD).

Methods

Whole-brain CTP and four-dimensional CT angiography (4D-CTA) images were acquired in 30 MCI, 35 mild AD patients, 35 moderate AD patients, 30 severe AD patients and 50 normal controls (NC). Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and correlation between CTP and 4D-CTA were analysed.

Results

Elevated CBF in the left frontal and temporal cortex was found in MCI compared with the NC group. However, TTP was increased in the left hippocampus in mild AD patients compared with NC. In moderate and severe AD patients, hypoperfusion was found in multiple brain areas compared with NC. Finally, we found that the extent of arterial stenosis was negatively correlated with CBF in partial cerebral cortex and hippocampus, and positively correlated with TTP in these areas of AD and MCI patients.

Conclusions

Our findings suggest that whole-brain CTP and 4D-CTA could serve as a diagnostic modality in distinguishing MCI and AD, and predicting conversion from MCI based on TTP of left hippocampus.

Key Points

• Whole-brain perfusion using the full 160-mm width of 320 detector rows

• Provide clinical experience of 320-row CT in cerebrovascular disorders of Alzheimerʼs disease

• Initial combined 4D CTA-CTP data analysed perfusion and correlated with CT angiography

• Whole-brain CTP and 4D-CTA have high value for monitoring MCI to AD progression

• TTP in the left hippocampus may predict the transition from MCI to AD

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Acknowledgements

This work was supported by The Shanghai Municipal Science and Technology Commission medical guide project no.134119b2100, 16411969200; Shanghai Municipal Commission of Health and Family Planning project no. 201640035.

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Authors and Affiliations

  1. Department of Medical Imaging, Tongji Hospital, Medical School of Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200065, People’s Republic of China

    Bo Zhang, Guo-jun Gu, Hong Jiang & Yi Guo

  2. Department of Radiology, Traditional Chinese Hospital, No.189, Chaoyangxi Road, Kun Shan, 215300, Jiangsu Province, People’s Republic of China

    Xing Shen

  3. Department of Medical Imaging, Renji Hospital, Medical School of Jiaotong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People’s Republic of China

    Bo Li & Wei Zhang

Authors
  1. Bo Zhang
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  2. Guo-jun Gu
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  5. Xing Shen
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Correspondence to Wei Zhang.

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Guarantor

The scientific guarantor of this publication is Zhang Wei. E-mail: zhangwei976@163.com.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

Case-control study, performed at one institution.

Additional information

Zhang Bo and Gu Guojun are considered as first authors.

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Zhang, B., Gu, Gj., Jiang, H. et al. The value of whole-brain CT perfusion imaging and CT angiography using a 320-slice CT scanner in the diagnosis of MCI and AD patients. Eur Radiol 27, 4756–4766 (2017). https://doi.org/10.1007/s00330-017-4865-1

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  • DOI: https://doi.org/10.1007/s00330-017-4865-1

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