【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。更多还原

【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 signifi cantly 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.更多还原