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Amide Proton Transfer MRI Could Be Used to Evaluate the Pathophysiological Status of White Matter Hyperintensities
Zixuan Guo1,2, Zhuoni Meng1,2, Ronghua Mu1,2
1Department of Medical Imaging, Guilin Medical University, Guilin, China.
Background:
The pathophysiology of white matter hyperintensities (WMH) remains unclear, investigations of amide proton transfer (APT) signals in WMH disease may provide relevant pathophysiological information.
Purpose:
To evaluate the APT signals differences and heterogeneity of WMH and adjacent normal-appearing white matter (NAWM) at different Fazekas grades and different locations.
Study Type:
Prospective.
Population:
In all, 180 WMH patients (age, 40-76; male/female, 77/103) and 59 healthy controls (age, 42-70; male/female, 23/36).
Field Strength/Sequence:
A 3 T; 3D fluid-attenuated inversion recovery (FLAIR), 3D APT-weighted (APTw).
Assessment:
The mean APTw values (APTwmean ) and the APTw signals heterogeneity (APTwmax-min ) among different grades WMH and NAWM and the APTwmean of the same grade deep WMH (DWMH) and paraventricular WMH (PWMH) were calculated and compared. Regions of interests were delineated on WMH lesions, NAWM and healthy white matter.
Statistical Tests:
One-way analysis of variance (ANOVA); independent sample t test; Chi-square test. Significance level: P < 0.05.
Results:
APTwmean among different grade WMH (from grade 0 to 3, 0.58 ± 0.14% vs. 0.29 ± 0.23% vs. 0.37 ± 0.24% vs. 0.61 ± 0.22%, respectively) were significantly different except between grade 1 and 2 (P = 0.27) and between grade 0 and 3 (P = 0.97). The differences in APTwmean between WMH and NAWM were significant (WMH vs. NAWM from grade 1 to 3, 0.29% ± 0.23% vs. 0.55% ± 0.27%; 0.37% ± 0.24% vs. 0.59% ± 0.22%; 0.61% ± 0.22% vs. 0.42% ± 0.24%, respectively). Lower APTwmean values were found only in grade 3 NAWM than other grades NAWM and controls. The APTwmax-min values of grade 1-3 WMH (0.38% ± 0.27% vs. 0.51% ± 0.31% vs. 0.67% ± 0.34%, respectively) were significantly different. Higher APTmean values were found only in grade 2 PWMH (0.47% ± 0.22% vs. 0.32% ± 0.24%).
Data Conclusion:
Significant differences of APT signals were found in WMH of different Fazekas grades and different locations.
Evidence Level:
2 TECHNICAL EFFICACY: Stage 3.
Insights
Amide proton transfer (APT) signals reveal significant differences in white matter hyperintensities (WMH) across various grades and locations. These findings offer new insights into WMH pathophysiology and disease progression.
Area of Science:
- Neuroimaging
- Biophysics
- Medical Physics
Background:
- The underlying pathophysiology of white matter hyperintensities (WMH) is not fully understood.
- Amide proton transfer (APT) signal investigations in WMH may offer crucial pathophysiological insights.
Purpose of the Study:
- To investigate differences and heterogeneity in APT signals between WMH and adjacent normal-appearing white matter (NAWM).
- To analyze these differences across varying Fazekas grades and WMH locations.
Main Methods:
- A prospective study involving 180 WMH patients and 59 healthy controls.
- Utilized 3 Tesla MRI with 3D FLAIR and 3D APT-weighted (APTw) sequences.
- Calculated and compared mean APTw values (APTwmean) and signal heterogeneity (APTwmax-min) in WMH, NAWM, and healthy white matter.
Main Results:
- Significant differences in APTwmean were observed across WMH grades (0-3), with notable variations between WMH and NAWM.
- APTwmax-min values showed significant differences in WMH across grades 1-3.
- Grade 2 periventricular WMH (PWMH) exhibited higher APTmean values compared to other grades.
Conclusions:
- APT signal analysis reveals significant variations in WMH based on Fazekas grade and location.
- These findings contribute to a better understanding of WMH pathophysiology.
