Analysis of brain and cerebrospinal fluid volumes with MR imaging: impact on PET data correction for atrophy. Part II. Aging and Alzheimer dementia.

A new, computerized segmentation technique, in which magnetic resonance (MR) imaging produces accurate volumetric measurements of brain and cerebrospinal fluid (CSF) without the limitations of computed tomography, was used in a retrospective analysis of digitized T2-weighted MR images of 16 healthy elderly control subjects and 16 patients with Alzheimer dementia. Ventricular and extraventricular CSF was quantified, and the effects of aging were studied; in both groups, the atrophy measurement was used to correct metabolic values obtained with positron emission tomography. Patients with Alzheimer dementia had higher total CSF; extraventricular, total ventricular, and third ventricular CSF volumes (49%, 37%, 99%, and 74%, respectively); and 7% lower brain volumes than the control group. The patients also showed a more marked decline in brain volumes and a greater increase in CSF volumes with advancing age than the control group. They had a 25.0% increase in corrected whole-brain metabolic rates; the control group had only a 15.8% increase. The use of this technique may provide a basis for further studies of aging and dementia, including regional volume analysis.