Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Evaluation of White Matter Abnormality in Mild Alzheimer Disease and Mild Cognitive Impairment Using Diffusion Tensor Imaging: A Comparison of Tract-Based Spatial Statistics with Voxel-Based Morphometry

확산텐서영상을 이용한 경도의 알츠하이머병 환자와 경도인지장애 환자의 뇌 백질의 이상평가: Tract-Based Spatial Statistics와 화소기반 형태분석 방법의 비교

  • Lim, Hyun-Kyung (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Sang-Joon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Choong-Gon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Jae-Hong (Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Seong-Yoon (Department of Psychiatry and Health Promotion Center, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Heng-Jun J. (Division of Magnetic Resonance, Korea Basic Science Institute) ;
  • Kim, Nam-Kug (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jahng, Geon-Ho (Department of Radiology, Kyung Hee East-West Neo Medial Center, Kyung Hee University College of Medicine)
  • 임현경 (울산대학교 서울아산병원 영상의학과) ;
  • 김상준 (울산대학교 서울아산병원 영상의학과) ;
  • 최충곤 (울산대학교 서울아산병원 영상의학과) ;
  • 이재홍 (울산대학교 서울아산병원 신경과) ;
  • 김성윤 (울산대학교 서울아산병원 정신건강의학과) ;
  • 김형준 (한국기초과학지원연구원 자기공명연구부) ;
  • 김남국 (울산대학교 서울아산병원 영상의학과) ;
  • 장건호 (강동경희대학교병원 영상의학과)
  • Received : 2012.03.19
  • Accepted : 2012.07.05
  • Published : 2012.08.31
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Abstract

Purpose : To evaluate white matter abnormalities on diffusion tensor imaging (DTI) in patients with mild Alzheimer disease (AD) and mild cognitive impairment (MCI), using tract-based spatial statistics (TBSS) and voxel-based morphometry (VBM). Materials and Methods: DTI was performed in 21 patients with mild AD, in 13 with MCI and in 16 old healthy subjects. A fractional anisotropy (FA) map was generated for each participant and processed for voxel-based comparisons among the three groups using TBSS. For comparison, DTI data was processed using the VBM method, also. Results: TBSS showed that FA was significantly lower in the AD than in the old healthy group in the bilateral anterior and right posterior corona radiata, the posterior thalamic radiation, the right superior longitudinal fasciculus, the body of the corpus callosum, and the right precuneus gyrus. VBM identified additional areas of reduced FA, including both uncinates, the left parahippocampal white matter, and the right cingulum. There were no significant differences in FA between the AD and MCI groups, or between the MCI and old healthy groups. Conclusion: TBSS showed multifocal abnormalities in white matter integrity in patients with AD compared with old healthy group. VBM could detect more white matter lesions than TBSS, but with increased artifacts.

목적: Tract-based spatial statistics와 화소기반 형태분석 방법을 이용하여 경도의 알츠하이머병 환자와 경도인 지장애 환자에서 확산텐서영상을 이용하여 뇌 백질의 이상을 평가하고자 하였다. 대상과 방법: 21명의 경도의 알츠하이머병 환자와 13명의 경도인지장애 환자, 그리고 16명의 건강한 노인군을 대상으로 확산텐서영상을 시행하였다. 각 참가자마다 분할 비등방도를 구하여 Tract-based spatial statistics를 이용하여 세 그룹간의 비교를 하였다. Tract-based spatial statistics 방법과의 비교를 위하여, 화소기반 형태분석 방법을 이용한 분석도 함께 시행하였다. 결과: Tract-based spatial statistics 분석결과, 경도의 알츠하이머 환자에서 건강한 노인군보다 방사관의 양측 전각과 우측 후각, 후시상방사, 우측 상세로다발, 뇌량체부, 우측 쐐기전소엽이랑에서 분할 비등방도가 유의하게 감소하였다. 화소기반 형태분석에서는 양측 갈고리다발, 좌측 부해마회의 백질, 우측 대상다발에서 추가적으로 분할 비등 방도가 감소되어 있었다. 경도의 알츠하이머 환자군과 경도인지장애 환자군의 비교, 경도인지장애 환자군과 건강한 노인군의 비교연구에서는 분할 비등방도의 유의한 차이는 없었다. 결론: Tract-based spatial statistics 분석결과, 경도의 알츠하이머 환자군에서 건강한 노인군에 비해 뇌 백질의 분할 비등방도가 여러 곳에서 감소되어 있었다. 화소기반 형태분석방법은 tract-based spatial statistics보다 더 많은 곳에서 뇌 백질의 이상을 보였다. 그러나, 인공물 또한 더 많이 관찰되었다.

Keywords

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