title: The value of diffusion tensor imaging in the differential diagnosis of subcortical ischemic vascular dementia and Alzheimer's disease in patients with only mild white matter alterations on T2-weighted images.
abstract: BACKGROUND
  Diffusion tensor imaging (DTI) is a form of functional magnetic resonance imaging (MRI) that allows examination of the microstructural integrity of white matter in the brain. Dementia is a neurodegenerative disease, and DTI can provide indirect insights of the microstructural characteristics of brains in individuals with different forms of dementia.
  
  
  OBJECTIVE
  To evaluate the value of DTI in the diagnosis and differential diagnosis of patients with subcortical ischemic vascular dementia (SIVD) and Alzheimer's disease (AD).
  
  
  METHODS
  The study included 40 patients (20 AD patients and 20 SIVD patients) and 20 normal controls (NC). After routine MRI and DTI, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured and compared in regions of interest (ROI).
  
  
  RESULTS
  Compared to NC and AD patients, SIVD patients had lower FA values and higher ADC values in the inferior-fronto-occipital fascicles (IFOF), genu of the corpus callosum (GCC), splenium of the corpus callosum (SCC), and superior longitudinal fasciculus (SLF). Compared to controls and SIVD patients, AD patients had lower FA values in the anterior frontal lobe, temporal lobe, hippocampus, IFOF, GCC, and CF; and higher ADC values in the temporal lobe and hippocampus.
  
  
  CONCLUSIONS
  DTI can be used to estimate the white matter impairment in dementia patients. There were significant regional reductions of FA values and heightened ADC values in multiple regions in SIVD patients compared to AD patients. When compared with conventional MRI, DTI may provide a more objective method for the differential diagnosis of SIVD and AD disease patients who have only mild white matter alterations on T2-weighted imaging.
authors.affiliation: Department of Neurology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, China.
authors.forename: Jian-Liang
authors.initials: JL
authors.lastname: Fu
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Chang
authors.forename: Yu-Zhen
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Li
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D016880:Anisotropy; D001921:Brain / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D015140:Dementia, Vascular / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012720:Severity of Illness Index