Assessment of cerebral blood flow in Alzheimer's disease by spin-labeled magnetic resonance imaging

To evaluate the utility of arterial spin-labeled blood flow magnetic resonance imaging for the detection of cerebral blood flow abnormalities in Alzheimer's disease, arterial spin-labeled blood flow images in 16 contiguous 5-mm axial sections were acquired in 18 patients diagnosed with probable Alzheimer's disease and 11 age-matched controls. Blood flow images from all subjects were transformed to a standard anatomical space for voxel-by-voxel statistical analysis. High quality blood flow images were obtained from all but 1 subject. Statistical analysis demonstrated significant flow decreases relative to control subjects in temporal, parietal, frontal, and posterior cingulate cortices. Increased severity of disease, as measured by Mini-Mental State Examination, correlated with posterior parietal and posterior cingulate decreases but not temporal decreases. Arterial spin-labeled magnetic resonance imaging was found to be an effective tool for characterizing flow decreases accompanying Alzheimer's disease. The absence of ionizing radiation or injection and the ability to obtain high quality anatomical images within the same scanning session make arterial spin labeling an attractive technique for the study of Alzheimer's disease, for the evaluation of pharmacological therapies, and, possibly, for early diagnosis.