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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

31卷

期数:

2025年03期

页码:

274-279

栏目:

临床医学

出版日期:

2025-05-20

文章信息/Info

Title:

Diagnostic value of DTI-ALPS index and BG PVS-VF in brain glymphatic system alterations in Alzheimer′s disease

文章编号:

1006-8147(2025)03-0274-06

作者:

韩俊玲¹; 焦欢静¹; 夏燕来¹; 倪红艳²

（1. 天津医科大学一中心临床学院，天津 300192；2. 天津市第一中心医院放射科，天津 300074）

Author(s):

HAN Junling¹; JIAO Huanjing¹; XIA Yanlai¹; NI Hongyan²

（1.The First Central Clinical College，Tianjin Medical University，Tianjin 300192，China；2.Department of Radiology，Tianjin First Central Hospital，Tianjin 300074，China）

关键词:

阿尔茨海默病; DTI-ALPS 指数; 血管周围间隙体积分数; 脑类淋巴系统

Keywords:

Alzheimer′s disease; DTI-ALPS index; perivascular space volume fraction; brain glymphatic system

分类号:

R445.2

DOI:

10.20135/j.issn.1006-8147.2025.03.0274

文献标志码:

A

摘要:

目的：探究DTI-ALPS指数和基底节血管周围间隙体积分数（BG PVS-VF）对阿尔茨海默病（AD）的诊断价值。方法：纳入AD神经影像计划3队列的28例典型AD（AD）、36例轻度认知障碍（MCI）和67例认知正常（CN）受试者，分为AD、MCI和CN组。受试者均进行了扩散张量成像和三维T1加权磁共振扫描，计算DTI-ALPS指数、BG PVS-VF。进行3组间DTI-ALPS指数和BG PVS-VF的比较，分析DTI-ALPS指数和BG PVS-VF与临床数据，包括年龄、受教育年限、APOE ε4携带状态的相关性，在控制年龄因素后，分析二者与简易精神状态量表（MMSE）评分的相关性。利用受试者工作特征（ROC）曲线评估DTI-ALPS指数、BG PVS-VF对AD的诊断效能。结果：与CN组和MCI组相比，AD组的DTI-ALPS指数均显著减低（95%CI：0.041~0.170和95%CI：0.005~0.150，均P<0.05）。3组间的BG PVS-VF未观察到显著差异（H=0.83，P=0.66）。DTI-ALPS指数与年龄（r=-0.20）、MMSE评分（r=0.27）显著相关（均P<0.05）。BG PVS-VF与年龄（r=0.34）、MMSE评分（r=0.19）显著相关（均P<0.05）。DTI-ALPS指数诊断MCI的曲线下面积（AUC）为0.59，无诊断价值（P>0.05）；诊断AD的AUC更大，具有诊断价值（AUC=0.76，P<0.001）。结论：AD患者脑类淋巴系统活性降低和结构改变与认知障碍相关，DTI-ALPS指数对AD具有诊断价值。

Abstract:

Objective：To investigate the diagnostic value of the DTI-ALPS index and Basal Ganglia Perivascular Space Volume Fraction （BG PVS-VF） in Alzheimer′s disease （AD）. Methods：A total of 28 patients with typical AD，36 individuals with mild cognitive impairment （MCI），and 67 cognitively normal （CN） subjects from the Alzheimer′s Disease Neuroimaging Initiative 3 （ADNI-3） cohort were enrolled and divided into AD，MCI，and CN group. All participants underwent diffusion tensor imaging （DTI） and 3D T1-weighted magnetic resonance imaging （MRI）. The DTI-ALPS index and BG PVS-VF were calculated. Comparisons of the DTI-ALPS index and BG PVS-VF among the three groups were performed. Correlations between DTI-ALPS index and BG PVS-VF with clinical data，including age，years of education，and APOE ε 4 carrier status were analyzed. Partial correlation analysis controlling for age was conducted to assess their associations with Mini-Mental State Examination （MMSE） scores. Receiver operating characteristic （ROC） curves were used to evaluate the diagnostic performance of the DTI-ALPS index and BG PVS-VF for AD. Results：The DTI-ALPS index was significantly reduced in the AD group compared with the MCI group and CN group （95% CI：0.005-0.150 and 95% CI：0.041-0.170，all P<0.05）. No significant differences in BG PVS-VF were observed among the three groups （H=0.83，P=0.66）. The DTI-ALPS index showed significant correlations with age （r=0.20） and MMSE scores （r=0.27） （both P<0.05）. BG PVS-VF was significantly correlated with age （r=0.34，P<0.05） and MMSE scores （r=0.19，P<0.05）. The DTI-ALPS index demonstrated an area under the curve （AUC） of 0.59 for diagnosing MCI，indicating no diagnostic value （P>0.05），whereas it showed a significantly larger AUC for diagnosing AD （AUC=0.76，P<0.001），supporting its diagnostic utility. Conclusion：The reduced activity and structural alterations of brain glymphatic system in AD patients are associated with cognitive impairment，and the DTI-ALPS index exhibits diagnostic value for AD.

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备注/Memo

备注/Memo:

基金项目: 天津市科技计划项目（21JCZDJC01210）
作者简介: 韩俊玲（1999-），女，硕士在读，研究方向：医学影像技术；
通信作者：倪红艳，E-mail：hongyni@163.com。

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更新日期/Last Update: 2025-06-01