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Differential Diagnosis of Normal Pressure Hydrocephalus by MRI Mean Diffusivity Histogram Analysis

Differential Diagnosis of Normal Pressure Hydrocephalus by MRI Mean Diffusivity Histogram Analysis BACKGROUND AND PURPOSE: Accurate diagnosis of normal pressure hydrocephalus is challenging because the clinical symptoms and radiographic appearance of NPH often overlap those of other conditions, including age-related neurodegenerative disorders such as Alzheimer and Parkinson diseases. We hypothesized that radiologic differences between NPH and AD/PD can be characterized by a robust and objective MR imaging DTI technique that does not require intersubject image registration or operator-defined regions of interest, thus avoiding many pitfalls common in DTI methods. MATERIALS AND METHODS: We collected 3T DTI data from 15 patients with probable NPH and 25 controls with AD, PD, or dementia with Lewy bodies. We developed a parametric model for the shape of intracranial mean diffusivity histograms that separates brain and ventricular components from a third component composed mostly of partial volume voxels. To accurately fit the shape of the third component, we constructed a parametric function named the generalized Voss-Dyke function. We then examined the use of the fitting parameters for the differential diagnosis of NPH from AD, PD, and DLB. RESULTS: Using parameters for the MD histogram shape, we distinguished clinically probable NPH from the 3 other disorders with 86% sensitivity and 96% specificity. The technique yielded 86% sensitivity and 88% specificity when differentiating NPH from AD only. CONCLUSIONS: An adequate parametric model for the shape of intracranial MD histograms can distinguish NPH from AD, PD, or DLB with high sensitivity and specificity. ABBREVIATIONS: AD Alzheimer disease DLB dementia with Lewy bodies NPH normal pressure hydrocephalus MD mean diffusivity PD Parkinson disease http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Differential Diagnosis of Normal Pressure Hydrocephalus by MRI Mean Diffusivity Histogram Analysis

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References (42)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2013 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A3368
pmid
23257611
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Accurate diagnosis of normal pressure hydrocephalus is challenging because the clinical symptoms and radiographic appearance of NPH often overlap those of other conditions, including age-related neurodegenerative disorders such as Alzheimer and Parkinson diseases. We hypothesized that radiologic differences between NPH and AD/PD can be characterized by a robust and objective MR imaging DTI technique that does not require intersubject image registration or operator-defined regions of interest, thus avoiding many pitfalls common in DTI methods. MATERIALS AND METHODS: We collected 3T DTI data from 15 patients with probable NPH and 25 controls with AD, PD, or dementia with Lewy bodies. We developed a parametric model for the shape of intracranial mean diffusivity histograms that separates brain and ventricular components from a third component composed mostly of partial volume voxels. To accurately fit the shape of the third component, we constructed a parametric function named the generalized Voss-Dyke function. We then examined the use of the fitting parameters for the differential diagnosis of NPH from AD, PD, and DLB. RESULTS: Using parameters for the MD histogram shape, we distinguished clinically probable NPH from the 3 other disorders with 86% sensitivity and 96% specificity. The technique yielded 86% sensitivity and 88% specificity when differentiating NPH from AD only. CONCLUSIONS: An adequate parametric model for the shape of intracranial MD histograms can distinguish NPH from AD, PD, or DLB with high sensitivity and specificity. ABBREVIATIONS: AD Alzheimer disease DLB dementia with Lewy bodies NPH normal pressure hydrocephalus MD mean diffusivity PD Parkinson disease

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Jun 1, 2013

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