扩散权重成像的诊断准确性在克鲁茨菲尔特-雅各布病变体中
G Mackenzie1, D Summers2, J Mackenzie3
1National CJD Research and Surveillance Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. Graeme.mackenzie3@nhs.scot.
Neuroradiology
|October 13, 2023
概括
扩散加权成像 (DWI) 对克鲁茨菲尔特-雅各布病 (vCJD) 变体的脉动标志检测的灵敏度低于FLAIR. DWI更多地表明偶发性CJD (sCJD) 模式,需要在vCJD诊断中谨慎解释.
科学领域:
- 神经成像是一种神经成像.
- 子疾病是子疾病.
- 诊断辐射学 诊断辐射学
背景情况:
- 变体克鲁茨菲尔特-雅各布病 (vCJD) 是一种传染性病.
- 对于vCJD存在诊断挑战,特别是在异合性PRNP个体中.
- 扩散加权成像 (DWI) 对零星CJD (sCJD) 有价值,但其对vCJD的实用性尚不清楚.
研究的目的:
- 为了调查vCJD中DWI的诊断敏感性.
- 在vCJD案件中,将DWI发现与FLAIR进行比较.
- 评估DWI在区分vCJD和sCJD中的实用性.
主要方法:
- 专家神经放射学家对DWI和FLAIR图像进行了独立分析.
- 包括来自国家CJD研究和监督部门的可能和确定的vCJD案件.
- 在混合队列中对扫描进行审查,包括sCJD和非CJD对照.
主要成果:
- 在vCJD (p<0.001) 中,FLAIR序列对脉动标志的敏感度显著高 (73%),高于DWI (41%).
- 酒后饮酒 (84%) 发生的基底腺节强度过高比FLAIR (64%) 发生的频率更高.
- 皮层超强度仅限于DWI (24%),脉动标志对vCJD具有98%的特异性.
结论:
- 与FLAIR相比,DWI对vCJD脉动标志的敏感性降低了.
- DWI更好地识别基底和皮质过强度,模仿sCJD模式.
- 轴向FLAIR可能在vCJD中提供更精确的脉动标志评估,这需要谨慎的DWI解释.
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