European Radiology

, Volume 27, Issue 11, pp 4756–4766 | Cite as

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

  • Bo Zhang
  • Guo-jun Gu
  • Hong Jiang
  • Yi Guo
  • Xing Shen
  • Bo Li
  • Wei Zhang



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).


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.


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.


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


Mild cognitive impairment Alzheimer disease Whole brain CT perfusion CT angiography 



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.

Compliance with ethical standards


The scientific guarantor of this publication is Zhang Wei. E-mail:

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.


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.


Case-control study, performed at one institution.


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Bo Zhang
    • 1
  • Guo-jun Gu
    • 1
  • Hong Jiang
    • 1
  • Yi Guo
    • 1
  • Xing Shen
    • 2
  • Bo Li
    • 3
  • Wei Zhang
    • 3
  1. 1.Department of Medical Imaging, Tongji HospitalMedical School of Tongji UniversityShanghaiPeople’s Republic of China
  2. 2.Department of RadiologyTraditional Chinese HospitalKun ShanPeople’s Republic of China
  3. 3.Department of Medical Imaging, Renji HospitalMedical School of Jiaotong UniversityShanghaiPeople’s Republic of China

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