Marie Catherine Boll , Ignacio Muñoz-López , Graciela Cárdenas , Miguel Ángel Ramírez-García , María Guadalupe Nava-Galán , Petra Yescas-Gómez
{"title":"表观扩散系数测量。诊断克雅氏病的可靠工具","authors":"Marie Catherine Boll , Ignacio Muñoz-López , Graciela Cárdenas , Miguel Ángel Ramírez-García , María Guadalupe Nava-Galán , Petra Yescas-Gómez","doi":"10.1016/j.arcmed.2024.103104","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Purpose</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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<sup>–3</sup> mm<sup>2</sup>/s) at 0.5946 in the left anterior putamen vs. 0.8644 in the control encephalopathies (<em>p</em> < 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<sup>–3</sup> mm<sup>2</sup>/s, with no significant differences in this coefficient between sporadic and genetic cases.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Apparent Diffusion Coefficient Measurements. A Reliable Tool for the Diagnosis of Creutzfeldt-Jakob Disease\",\"authors\":\"Marie Catherine Boll , Ignacio Muñoz-López , Graciela Cárdenas , Miguel Ángel Ramírez-García , María Guadalupe Nava-Galán , Petra Yescas-Gómez\",\"doi\":\"10.1016/j.arcmed.2024.103104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Purpose</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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<sup>–3</sup> mm<sup>2</sup>/s) at 0.5946 in the left anterior putamen vs. 0.8644 in the control encephalopathies (<em>p</em> < 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<sup>–3</sup> mm<sup>2</sup>/s, with no significant differences in this coefficient between sporadic and genetic cases.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":8318,\"journal\":{\"name\":\"Archives of Medical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Medical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0188440924001553\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0188440924001553","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
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.
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.