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Combination of 3D-pCASL and diffusion kurtosis imaging in the diagnosis of subcortical arteriosclerotic encephalopathy
HE Xiaoyi  SHI Hao  WANG Junying 

Cite this article as: He XY, Shi H, Wang JY. Combination of 3D-pCASL and diffusion kurtosis imaging in the diagnosis of subcortical arteriosclerotic encephalopathy[J]. Chin J Magn Reson Imaging, 2021, 12(5): 60-64, 89. DOI:10.12015/issn.1674-8034.2021.05.013.


[Abstract] Objective To explore the diagnostic value of diffusion kurtosis imaging (DKI) and 3D pseudo continuous arterial spin labeling (3D-pCASL) technologies in subcortical arteriosclerotic encephalopathy (SAE). Materials andMethods Regular MRI, 3D-pCASL and DKI scans were performed on 35 clinically diagnosed SAE patients and 33 control groups. The fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr), anisotropy fraction of kurtosis (FAk), mean kurtosis (MK), axial kurtosis (Ka) and radial kurtosis (Kr) were measured in three groups including the lesion areas of white matter (WM) in SAE group (frontal and occipital WM around the horns of bilateral ventricle), normal WM area of SAE group (normal WM adjacent to the lesion area, the genu/splenium of the corpus callosum, and temporal WM) and ​​the control group. The CBF value was measured in SAE group (lesion areas, genu/splenium of the corpus callosum, and temporal WM) and the control group. These data acquired were statistically analyzed and the correlations between DKI/ASL derived parameters value and Mini-mental State Examination (MMSE) score of SAE patients were studied. The receiver operating characteristic (ROC) was used to analysis the diagnostic value in SAE by these two technologies.Results Compared with the control group, the SAE group had a significant decline in the values of CBF, FA and kurtosis parameters in all WM lesion areas, and the values of diffusion parameters increased considerably (P＜0.05). The significant changes, similar to WM lesions of SAE, were shown in some values of DKI parameters of the normal control group. Additionally, for SAE patients, MMSE showed positive correlation with CBF in parietal/temporal WM (r=0.496/0.392, P=0.003/0.020), and positively correlated with FA and Kr values of frontal WM around the horns of bilateral ventricle (r=0.488/0.437, P=0.003/0.009). Finally, FA in GCC, CBF in SCC, and the combined FA/MD/Dr/CBF in temporal WM showed high accuracy (AUCs 0.957/0.946/0.986) in distinguishing SAE patients from controls.Conclusions For SAE patients, the DKI and 3D-pCASL can sensitively detect the potential changes of brain microstructure with normal performance in regular MRI examinations, and these two techniques can detect the progression of cognitive dysfunction for SAE. Thus, DKI and 3D-ASL imaging were proven to effectively improve the diagnosis of SAE.
[Keywords] brain structure；subcortical arteriosclerotic encephalopathy；Binswanger's disease；diffusion kurtosis imaging；pseudo continuous arterial spin labeling

HE Xiaoyi1, 2   SHI Hao1*   WANG Junying1  

1 Department of Radiology, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, Shandong Lung Cancer Institute, Shandong Institute of Neuroimmunology, Jinan 250014, China

2 Shandong First Medical University, Jinan 250062, China

Shi H, E-mail: hansenschie@126.com

Conflicts of interest   None.

Received  2020-12-15
Accepted  2021-03-25
DOI: 10.12015/issn.1674-8034.2021.05.013
Cite this article as: He XY, Shi H, Wang JY. Combination of 3D-pCASL and diffusion kurtosis imaging in the diagnosis of subcortical arteriosclerotic encephalopathy[J]. Chin J Magn Reson Imaging, 2021, 12(5): 60-64, 89. DOI:10.12015/issn.1674-8034.2021.05.013.

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