Diagnostic value of intravoxel incoherent motion imaging of deep gray matter nuclei in Alzheimer's disease.

OBJECTIVE

To evaluate clinical diagnostic value of intravoxel incoherent motion (IVIM) imaging in Alzheimer's disease (AD).

METHODS

Sixty-six subjects from Ningde City Hospital were classified into AD (n = 23), mild cognitive impairment (MCI) (n = 28), and normal control (NC) (n = 15) groups. Standardized apparent diffusion coefficient (ADCst) and IVIM parameters, including true diffusion coefficient (D), perfusion fraction (f), and pseudo-diffusion coefficient (D*), were measured in the caudate nucleus, thalamus, putamen, globus pallidus, and amygdala using 3.0 T magnetic resonance imaging. Mini-mental state examination (MMSE) scores were recorded, and Pearson correlation and receiver operating characteristic analyses were performed.

RESULTS

IVIM-f in the right thalamus was significantly reduced in the AD group compared with the NC and MCI groups (p < 0.05), and IVIM-f in the bilateral amygdala was lower in AD than in NC (p < 0.01). IVIM-D* in the right caudate nucleus was significantly decreased in AD relative to both NC and MCI groups (p < 0.001), whereas IVIM-D in the left putamen was increased in AD compared with NC (p < 0.001). No significant intergroup difference was observed for ADCst (p > 0.05). Correlation analysis showed that MMSE scores were positively associated with IVIM-f in the right thalamus (r = 0.5471, p < 0.001), IVIM-D* in the right caudate nucleus (r = 0.6587, p < 0.001), and IVIM-f in the right amygdala (r = 0.6129, p < 0.0001), and negatively associated with IVIM-D in the left putamen (r =  - 0.5078, p < 0.001). ROC analysis showed that IVIM-f yielded higher AUC values than ADCst for distinguishing AD from non-AD participants (AUC = 0.7644 vs. 0.6643), NC from MCI participants (AUC = 0.8548 vs. 0.6571), and MCI from AD participants (AUC = 0.7205 vs. 0.6211); however, this comparison should be interpreted cautiously because ADCst did not show significant intergroup differences.

CONCLUSION

IVIM-derived parameters are closely associated with cognitive impairment severity and provide improved differentiation among AD, MCI, and normal controls, supporting their potential clinical utility for early diagnosis and disease assessment.