The Role of Arterial Spin Labeling, a Noninvasive MRI Perfusion Method, in Identifying an Abnormal Cerebral Perfusion Pattern in Parkinson's Disease

摘要

In clinical practice, conventional magnetic resonance imaging (cMRI) with visual assessment of T2- and T1-weighted imaging is a well-established method for the exclusion of other causes of parkinsonism including atypical parkinson-ism and symptomatic parkinsonism due to other pathologies. By using magnetically labeled arterial blood water as an endogenous tracer to provide quantitative cerebral blood flow (CBF) measurements, perfusion imaging with arterial spin labeling (ASL) contrast represents a noninvasive MRI perfusion method that quantitatively measures CBF per unit tissue mass. In this study, the authors measured cerebral gray matter perfusion using pseudo-continuous ASL in 61 subjects with Parkinson's disease (PD) compared with 29 age- and sex-matched controls. Motor impairment was assessed with part III of the Unified Parkinson's Disease Rating Scale (UPDRS part III) and global cognitive status with the Mini-Mental State Examination and the Montreal Cognitive Assessment (MoCA). PD patients were classified as cognitively normal (n = 34), with mild cognitive impairment (n = 16), or with dementia (n = 11). The authors identified a PD-related perfusion network by principal component analysis (ie, a data-driven technique that enables the unbiased detection of spatial covariance patterns) of ASL-MRI via logistic regression.