表观扩散系数测量。诊断克雅氏病的可靠工具

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Marie Catherine Boll , Ignacio Muñoz-López , Graciela Cárdenas , Miguel Ángel Ramírez-García , María Guadalupe Nava-Galán , Petra Yescas-Gómez
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引用次数: 0

摘要

背景和目的:克雅氏病(CJD)是一种罕见的快速致死性神经退行性疾病。确诊克雅氏病的金标准检测方法是组织病理学确认,通常是在死后进行;然而,在所有医疗机构中,尸检研究并不总是可行的:我们对 2008 年至 2019 年期间回顾性入组的疑似朊病毒病患者进行了横断面分析。只有病史完整且符合诊断清单的患者才被纳入。对磁共振成像(MRI)序列(T2-FLAIR和DWI)进行了分析,并计算了每个大脑半球五个感兴趣区(ROI)的表观弥散系数(ADC):共对 72 张磁共振成像扫描进行了后处理。该系列包括 47 例 CJD 病例,包括 25 例遗传性病例和 22 例散发性病例,以及 25 例年龄配对的非原发性脑病对照组病例。新纹状体的 ADC 值(×10-3 mm2/s)与对照组脑病的 ADC 值(×10-3 mm2/s)相比,差异最为显著,左侧前部丘脑的 ADC 值为 0.5946,对照组为 0.8644(P < 0.001;95% 置信区间:0.5751-0.6142 vs. 0.7812-0.9476),而其他 ROI 也有显著差异。区分CJD和其他脑病的最佳临界值为0.65×10-3 mm2/s,该系数在散发性病例和遗传性病例之间无明显差异:结论:在无法进行脑脊液实时震荡诱导转换或其他特异性错误折叠蛋白检测试验的情况下,基底节的定量 ADC 测量似乎是区分 CJD 和非先天性脑病的最有用的生前诊断工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Apparent Diffusion Coefficient Measurements. A Reliable Tool for the Diagnosis of Creutzfeldt-Jakob Disease

Background and Purpose

Creutzfeldt-Jakob disease (CJD) is a rare, rapidly fatal neurodegenerative disorder. The gold standard test for a positive diagnosis of definite CJD is histopathological confirmation, usually post-mortem; however, an autopsy study is not always feasible in all health settings.

Materials and Methods

We performed a cross-sectional analysis of a retrospectively enrolled cohort of patients with suspected prion disease between 2008 and 2019. Only patients with complete medical histories who fulfilled a diagnostic checklist were enrolled. The magnetic resonance imaging (MRI) sequences (T2-FLAIR and DWI) were analyzed, and the apparent diffusion coefficients (ADCs) were calculated for five regions of interest (ROIs) in each cerebral hemisphere.

Results

In total, 72 MRI scans were post-processed. The series included 47 cases of CJD, including 25 genetic and 22 sporadic cases, in addition to 25 age-paired controls with non-prion encephalopathies. The neostriatum showed the most significant difference in ADC values (×10–3 mm2/s) at 0.5946 in the left anterior putamen vs. 0.8644 in the control encephalopathies (p < 0.001; 95% confidence interval: 0.5751–0.6142 vs. 0.7812–0.9476), while the other ROIs also showed significant differences. The best cut-off value to differentiate CJD from other encephalopathies was identified as 0.65×10–3 mm2/s, with no significant differences in this coefficient between sporadic and genetic cases.

Conclusions

Quantitative ADC measurements made in the basal ganglia seem to be the most useful ante-mortem diagnostic tool for differentiating CJD from non-prion encephalopathies when cerebrospinal fluid real-time quaking-induced conversion or other specific misfolded protein detection tests are inaccessible.
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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