Differentiating between Alzheimer Disease Patients and Controls with Phase-difference-enhanced Imaging at 3T: A Feasibility Study.

PURPOSE: To test the feasibility of the phase difference enhanced (PADRE) imaging for differentiation between Alzheimer disease (AD) patients and control subjects on 3T MR imaging.

MATERIALS AND

METHODS

Fifteen patients with AD and 10 age-matched control subjects underwent two-dimensional fast field echo imaging to obtain PADRE images on a 3T MR scanner. A double Gaussian distribution model was used to determine the threshold phase value for differentiation between the physiologic and non-physiologic iron in the cerebral cortices, and PADRE images were processed with the threshold. Using a 4-point grading system, two readers independently assessed the signal of the four cerebral cortices on PADRE images: the cuneus, precuneus, superior frontal gyrus, and superior temporal gyrus. The difference in the signals in each cortex between the AD patients and age-matched control subjects was determined by using Mann-Whitney U test. Inter-rater reliability was determined by Kappa analysis. We also evaluated the correlation between Mini-Mental State Examination (MMSE) score and the hypointense grade, and between disease duration and the hypointense grade using the Spearman rank correlation test.

RESULTS

The threshold phase value for differentiation between the physiologic and non-physiologic iron was -4.6% π (radian). The mean grades of the cuneus, precuneus, and superior temporal gyrus were significantly higher for the AD patients than for the control subjects (P = 0.002). Excellent inter-rater reliability was seen in the precuneus (kappa = 0.93), superior temporal gyrus (kappa = 0.94), and superior frontal gyrus (kappa = 0.93); good inter-rater reliability was observed in the cuneus (kappa = 0.75). We found a statistical correlation between MMSE score and the hypointense grade in superior temporal gyrus (STG) (P = 0.008), and no correlation between disease duration and the hypointense grade in any gyrus.

CONCLUSION

Our results suggest the feasibility of PADRE imaging at 3T for differentiation between AD patients and control subjects.