Research progress of diffusion magnetic resonance imaging in the diagnosis of Alzheimer,s disease

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Research progress of diffusion magnetic resonance imaging in the diagnosis of Alzheimer's disease

MA Qianbo PAN Junlong WANG Tao YU Chengxin XU Yaka

Cite this article as MA Q B, PAN J L, WANG T, et al. Research progress of diffusion magnetic resonance imaging in the diagnosis of Alzheimer's disease[J]. Chin J Magn Reson Imaging, 2026, 17(6): 155-161. DOI:10.12015/issn.1674-8034.2026.06.020.

Abstract

[Abstract] Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive dysfunction and memory impairment, predominantly affecting middle-aged and elderly individuals. Its etiology and pathogenesis remain incompletely understood. In recent years, with the continuous advancement of magnetic resonance imaging techniques, diffusion magnetic resonance imaging (dMRI) has played an increasingly important role in the early diagnosis, differential diagnosis, and treatment monitoring of AD. Techniques applied in AD research include intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), aquaporin magnetic resonance molecular imaging (AQP-MRMI), diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). This review summarizes the application progress of the aforementioned dMRI techniques in AD, aiming to provide insights for early diagnosis and pathological mechanism research of AD.

[Keywords] Alzheimer's disease；mild cognitive impairment；magnetic resonance imaging；diffusion tensor imaging；intravoxel incoherent motion diffusion-weighted imaging；aquaporin magnetic resonance molecular imaging

Contributor Information

MA Qianbo^{1,
2}   PAN Junlong^{1,
2}   WANG Tao^{1,
2}   YU Chengxin^{1,
2}   XU Yaka^{1,
2*}

¹ The First College of Clinical Medical Science, China Three Gorges University, Yichang 443000, China

² Department of Radiology, Yichang Central People's Hospital, Yichang 443000, China

Corresponding author: XU Y K, E-mail: xyk_radiology@126.com

Conflicts of interest None.

Publication Information

Received 2026-01-13

Accepted 2026-06-09

DOI: 10.12015/issn.1674-8034.2026.06.020

Text

References

[1]

ZHANG J, ZHANG Y, WANG J, et al. Recent advances in Alzheimer's disease: Mechanisms, clinical trials and new drug development strategies[J/OL]. Signal Transduct Target Ther, 2024, 9(1): 211 [2026-01-13]. https://doi.org/10.1038/s41392-024-01911-3. DOI: 10.1038/s41392-024-01911-3.

[2]

SCHELTENS P, DE STROOPER B, KIVIPELTO M, et al. Alzheimer's disease[J]. Lancet, 2021, 397(10284): 1577-1590. DOI: 10.1016/S0140-6736(20)32205-4.

[3]

2024 Alzheimer's disease facts and figures[J]. Alzheimers Dement, 2024, 20(5): 3708-3821. DOI: 10.1002/alz.13809.

[4]

ZHI N, REN R, QI J L, et al. The China Alzheimer Report 2025[J/OL]. Gen Psych, 2025, 38: e102020 [2026-06-08]. https://doi.org/10.1136/gpsych-2024-102020. DOI: 10.1136/gpsych-2024-102020.

[5]

LE BIHAN D, BRETON E, LALLEMAND D, et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders[J]. Radiology, 1986, 161(2): 401-407. DOI: 10.1148/radiology.161.2.3763909.

[6]

WANG F, YAN C Y, WANG C H, et al. The Roles of Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion Diffusion-Weighted Imaging Parameters in Preoperative Evaluation of Pathological Grades and Microvascular Invasion in Hepatocellular Carcinoma[J/OL]. Front Oncol, 2022, 12: 884854 [2026-01-13]. https://doi.org/10.3389/fonc.2022.884854. DOI: 10.3389/fonc.2022.884854.

[7]

LUO H, HE L, CHENG W, et al. The diagnostic value of intravoxel incoherent motion imaging in differentiating high-grade from low-grade gliomas: a systematic review and meta-analysis[J/OL]. Br J Radiol, 2021, 94(1121): 20201321 [2026-01-13]. https://doi.org/10.1259/bjr.20201321. DOI: 10.1259/bjr.20201321.

[8]

PIRES T, PRIYANKA, KADAVIGERE R, et al. Quantitative estimation of intravoxel incoherent motion parameters in acute ischemic stroke: A Systematic review and meta-analysis[J/OL]. BMC Med Imaging, 2025, 25(1): 462 [2026-01-13]. https://doi.org/10.1186/s12880-025-01997-3. DOI: 10.1186/s12880-025-01997-3.

[9]

XING P Q, CHEN Q Y, ZHENG T X, et al. Value of intravoxel incoherent motion imaging in the clinical diagnosis of Alzheimer's disease[J]. Chin J Magn Reson Imaging, 2024, 15(9): 33-40. DOI: 10.12015/issn.1674-8034.2024.09.007.

[10]

VAN DER THIEL M M, FREEZE W M, VERHEGGEN I C M, et al. Associations of increased interstitial fluid with vascular and neurodegenerative abnormalities in a memory clinic sample[J]. Neurobiol Aging, 2021, 106: 257-267. DOI: 10.1016/j.neurobiolaging.2021.06.017.

[11]

XIA N, LI Y, XUE Y, et al. Intravoxel incoherent motion diffusion-weighted imaging in the characterization of Alzheimer's disease[J]. Brain Imaging Behav, 2022, 16(2): 617-626. DOI: 10.1007/s11682-021-00538-0.

[12]

BERGAMINO M, NESPODZANY A, BAXTER L C, et al. Preliminary Assessment of Intravoxel Incoherent Motion Diffusion-Weighted MRI (IVIM-DWI) Metrics in Alzheimer's Disease[J]. J Magn Reson Imaging, 2020, 52(6): 1811-1826. DOI: 10.1002/jmri.27272.

[13]

BERGAMINO M, BURKE A, BAXTER L C, et al. Longitudinal Assessment of Intravoxel Incoherent Motion Diffusion-Weighted MRI Metrics in Cognitive Decline[J]. J Magn Reson Imaging, 2022, 56(6): 1845-1862. DOI: 10.1002/jmri.28172.

[14]

AGRE P, PRESTON G M, SMITH B L, et al. Aquaporin CHIP: the archetypal molecular water channel[J]. Am J Physiol, 1993, 265(4): F463-F476. DOI: 10.1152/ajprenal.1993.265.4.F463.

[15]

ZHANG Z P, XING W, CHEN J. Mechanism and research progress of magnetic resonance aquaporin molecular imaging[J]. Radiol Prac, 2021, 36(8): 1064-1068. DOI: 10.13609/j.cnki.1000-0313.2021.08.022.

[16]

WANG X, SHU X, HE P, et al. Ultra-high b-value DWI accurately identifies isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas[J]. Eur Radiol, 2024, 34(10): 6751-6762. DOI: 10.1007/s00330-024-10708-5.

[17]

JIANG R, WANG Z, LIU J, et al. High b-Value and Ultra-High b-Value Diffusion Weighted MRI in Stroke[J]. J Magn Reson Imaging, 2025, 61(3): 1459-1469. DOI: 10.1002/jmri.29547.

[18]

CHAURASIA A, GOPAL N, DEHGHANI FIROUZABADI F, et al. Role of ultra-high b-value DWI in the imaging of hereditary leiomyomatosis and renal cell carcinoma (HLRCC)[J]. Abdom Radiol, 2023, 48(1): 340-349. DOI: 10.1007/s00261-022-03689-w.

[19]

BUCCELLATO F R, D'ANCA M, SERPENTE M, et al. The Role of Glymphatic System in Alzheimer's and Parkinson's Disease Pathogenesis[J/OL]. Biomedicines, 2022, 10(9): 2261 [2026-01-13]. https://doi.org/10.3390/biomedicines10092261. DOI: 10.3390/biomedicines10092261.

[20]

XUE Y N, ZHANG Z H, WEN C Y, et al. Characterization of Alzheimer's disease using ultra-high b-values apparent diffusion coefficient and diffusion kurtosis imaging[J]. Aging Dis, 2019, 10(5): 1026-1036. DOI: 10.14336/AD.2018.1127.

[21]

QIU Y H, CHEN Q Y, SHI L W, et al. Value of multi-b-value diffusion-weighted imaging in the clinical diagnosis of Alzheimer's disease[J]. Chin J Magn Reson Imaging, 2023, 14(12): 6-14. DOI: 10.12015/issn.1674-8034.2023.12.002.

[22]

SHI L W, CHEN Q Y, CHEN T T, et al. Magnetic resonance molecular imaging of aquaporins in hippocampal subregions in Alzheimer's disease[J]. Chin J Magn Reson Imaging, 2024, 15(8): 65-72, 83. DOI: 10.12015/issn.1674-8034.2024.08.010.

[23]

BASSER P J, MATTIELLO J, LEBIHAN D. MR diffusion tensor spectroscopy and imaging[J]. Biophys J, 1994, 66(1): 259-267. DOI: 10.1016/S0006-3495(94)80775-1.

[24]

YANG H, DONG C, CAI Y, et al. Advances in the use of structural and diffusion magnetic resonance imaging for characterizing SCD and MCI due to Alzheimer's disease[J/OL]. Front Neurosci, 2025, 19: 1596459 [2026-01-13]. https://doi.org/10.3389/fnins.2025.1596459. DOI: 10.3389/fnins.2025.1596459.

[25]

BRUEGGEN K, DYRBA M, KILIMANN I, et al. Hippocampal mean diffusivity for the diagnosis of dementia and mild cognitive impairment in primary care[J]. Curr Alzheimer Res, 2018, 15(11): 1005-1012. DOI: 10.2174/1567205015666180613114829.

[26]

MAGALHÃES T N C, CASSEB R F, GERBELLI C L B, et al. Whole-brain DTI parameters associated with tau protein and hippocampal volume in Alzheimer's disease[J/OL]. Brain Behav, 2023, 13(2): e2863 [2026-01-13]. https://doi.org/10.1002/brb3.2863. DOI: 10.1002/brb3.2863.

[27]

OHLHAUSER L, PARKER A F, SMART C M, et al. White matter and its relationship with cognition in subjective cognitive decline[J]. Alzheimers Dement, 2018, 11: 28-35. DOI: 10.1016/j.dadm.2018.10.008.

[28]

BRUEGGEN K, DYRBA M, CARDENAS-BLANCO A, et al. Structural integrity in subjective cognitive decline, mild cognitive impairment and Alzheimer's disease based on multicenter diffusion tensor imaging[J]. J Neurol, 2019, 266(10): 2465-2474. DOI: 10.1007/s00415-019-09429-3.

[29]

YU J, LAM C L M, LEE T M C. White matter microstructural abnormalities in amnestic mild cognitive impairment: A meta-analysis of whole-brain and ROI-based studies[J]. Neurosci Biobehav Rev, 2017, 83: 405-416. DOI: 10.1016/j.neubiorev.2017.10.026.

[30]

LI X L, ZHANG H X, YANG M, et al. Application of diffusion tensor imaging technology in the pathological process of Alzheimer's disease[J]. Journal of Molecular Imaging, 2025, 48(8): 1028-1033. DOI: 10.12122/j.issn.1674-4500.2025.08.17.

[31]

GIULIETTI G, TORSO M, SERRA L, et al. Whole brain white matter histogram analysis of diffusion tensor imaging data detects microstructural damage in mild cognitive impairment and Alzheimer's disease patients[J]. J Magn Reson Imaging, 2018, 49(1): 233-242. DOI: 10.1002/jmri.25947.

[32]

BOESPFLUG E L, STORRS J, SADAT-HOSSIENY S, et al. Full diffusion characterization implicates regionally disparate neuropathology in mild cognitive impairment[J]. Brain Struct Funct, 2014, 219(1): 367-379. DOI: 10.1007/s00429-013-0506-x.

[33]

SHIH N C, KURNIAWAN N D, CABEEN R P, et al. Microstructural mapping of dentate gyrus pathology in Alzheimer's disease: a 16.4 Tesla MRI study[J/OL]. Neuroimage Clin, 2023, 37: 103318 [2026-01-13]. https://doi.org/10.1016/j.nicl.2023.103318. DOI: 10.1016/j.nicl.2023.103318.

[34]

ZHANG H, SCHNEIDER T, WHEELER-KINGSHOTT C A, et al. NODDI: practical in vivo neurite orientation dispersion and density imaging of the human brain[J]. Neuroimage, 2012, 61(4): 1000-1016. DOI: 10.1016/j.neuroimage.2012.03.072.

[35]

FU X, SHRESTHA S, SUN M, et al. Microstructural white matter Alterations in mild cognitive impairment and Alzheimer's disease : study based on neurite orientation dispersion and density imaging (NODDI)[J]. Clin Neuroradiol, 2020, 30(3): 569-579. DOI: 10.1007/s00062-019-00805-0.

[36]

KRAGULJAC N V, GUERRERI M, STRICKLAND M J, et al. Neurite Orientation Dispersion and Density Imaging in Psychiatric Disorders: A Systematic Literature Review and a Technical Note[J]. Biol Psychiatry Glob Open Sci, 2022, 3(1): 10-21. DOI: 10.1016/j.bpsgos.2021.12.012.

[37]

VOGT N M, HUNT J F, ADLURU N, et al. Cortical microstructural alterations in mild cognitive impairment and Alzheimer's disease dementia[J]. Cereb Cortex, 2020, 30(5): 2948-2960. DOI: 10.1093/cercor/bhz286.

[38]

PARKER D M, ADAMS J N, KIM S, et al. NODDI-derived measures of microstructural integrity in medial temporal lobe white matter pathways are associated with Alzheimer's disease pathology and cognition[J/OL]. Imaging Neurosci, 2025, 3: IMAG.a.950[2026-01-13]. https://doi.org/10.1162/IMAG.a.950. DOI: 10.1162/IMAG.a.950.

[39]

PILLAI J J, REID R I, WEIGAND S D, et al. Associations between temporal lobe cortical NODDI measures and memory function in individuals without clinical dementia[J/OL]. Alzheimers Dement, 2025, 21(6): e70384 [2026-01-13]. https://doi.org/10.1002/alz.70384. DOI: 10.1002/alz.70384.

[40]

LAVROVA A, PHAM N T T, REID R I, et al. Relation of Alzheimer's disease-related TDP-43 proteinopathy to metrics from diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI)[J]. Neurobiol Aging, 2025, 150: 97-108. DOI: 10.1016/j.neurobiolaging.2025.03.001.

[41]

ILIFF J J, WANG M, LIAO Y, et al. A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β[J/OL]. Sci Transl Med, 2012, 4(147): 147ra111 [2026-01-13]. https://doi.org/10.1126/scitranslmed.3003748. DOI: 10.1126/scitranslmed.3003748.

[42]

KEIL S A, JANSSON D, BRAUN M, et al. Glymphatic dysfunction in Alzheimer's disease: A critical appraisal[J/OL]. Science, 2025, 389(6756): eadv8269 [2026-01-13]. https://doi.org/10.1126/science.adv8269. DOI: 10.1126/science.adv8269.

[43]

TAOKA T, ITO R, NAKAMICHI R, et al. Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study[J]. Jpn J Radiol, 2021, 40(2): 147-158. DOI: 10.1007/s11604-021-01187-5.

[44]

STEWARD C E, VENKATRAMAN V K, LUI E, et al. Assessment of the DTI-ALPS Parameter Along the Perivascular Space in Older Adults at Risk of Dementia[J]. J Neuroimaging, 2021, 31(3): 569-578. DOI: 10.1111/jon.12837.

[45]

ZHONG J, WANG L, LI Y, et al. A Novel Diffusion Tensor Image Analysis Along the Perivascular Space Method to Evaluate Glymphatic Alterations in Alzheimer's Disease[C]//Annu Int Conf IEEE Eng Med Biol Soc, 2023: 1-4. DOI: 10.1109/EMBC40787.2023.10340315.

[46]

LIANG T, CHANG F, HUANG Z, et al. Evaluation of glymphatic system activity by diffusion tensor image analysis along the perivascular space (DTI-ALPS) in dementia patients[J/OL]. Br J Radiol, 2023, 96(1146): 20220315 [2026-01-13]. https://doi.org/10.1259/bjr.20220315. DOI: 10.1259/bjr.20220315.

[47]

HUANG S Y, ZHANG Y R, GUO Y, et al. Glymphatic system dysfunction predicts amyloid deposition, neurodegeneration, and clinical progression in Alzheimer's disease[J]. Alzheimers Dement, 2024, 20(5): 3251-3269. DOI: 10.1002/alz.13789.

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