ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Combined Educational & Scientific Session


SKILL LEVEL: Intermediate

ORGANIZERS: Jonathan H. Gillard, M.D., FRCR, MBA & Howard A Rowley, M.D.

Monday 1 June 2015

The use of imaging in the diagnosis of dementias is complex, most volumetric changes happening later in the disease. This session will explain the main phenotypes of dementia and the contributions that MR can make in the diagnosis and monitoring of these complex diseases.

Target Audience
This session will describe the spectrum of changes seen in dementias initially from a clinical perspective and then from an MR imaging perspective exploring the added value of multiparametric MR. This will benefit both physicists and clinicians involved in their evaluation and care.

Educational Objectives
As a result of attending this course, participants should be able to:
• Construct a differential diagnosis of dementias from a clinical perspective;
• Recognize the spectrum of conventional MR changes seen within the different dementias; and
• Demonstrate the added value of multiparametric MRI in the setting of dementia.

Moderators: Howard A. Rowley, M.D., Greg Zaharchuk, M.D., Ph.D.
14:15   Recent Advances in the Understanding of Dementias
Aya M. Tokumaru, Ph.D.
14:45 0171.   Magnetic Resonance Elastography of Normal Pressure Hydrocephalus
Nikoo Fattahi1, Arvin Arani1, Kevin J Glaser1, Armando Manduca1, Nicholas M Wetjen2, Perry Avital2, Richard L Ehman1, and John Huston III1
1Radiology, Mayo Clinic, Rochester, Minnesota, United States, 2Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States

MR Elastography using a 3T scanner and shear waves of 60 Hz was performed on patients with normal pressure hydrocephalus. A post-processing technique was applied to calculate brain elasticity that included whole brain as well as lobar stiffness. Results demonstrated an increase in brain stiffness of patients with NPH compared with age and sex matched normal controls.

15:05 0172.   
Diffusion Tensor Imaging Detects White Matter Changes in Preclinical Stages of Alzheimer Disease
Qing Wang1, Yong Wang1, Joshua S. Shimony1, Anne M. Fagan2, John C. Morris2, and Tammie L.S. Benzinger1,3
1Radiology, Washington University School of Medicine, St. Louis, MO, United States, 2Neurology, Washington University School of Medicine, St. Louis, MO, United States, 3Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States

Alzheimer disease (AD) affects 20-30 million people worldwide. DTI was utilized on 144 normal participants, 30 and 18 in preclinical stage1 and 2 respectively. DTI radial, axial and mean diffusivities significantly decreased in multiple white matter regions in stage1, and pseudo-normalized at stage 2. One explanation would be an early stage of microglia cell activation after amyloid deposition and BBB disruption and later concurrent involvement of axon damage, cell infiltration and edema. Monte Carlo simulation confirmed DTI findings. This study suggested that advanced diffusion MRI can potentially be used to improve risk stratification and early treatment efficacy for preclinical AD.

15:25 0173.   APOE ε4 Allele Status Influences Early Neurodevelopment
Justin M Remer1, Douglas C Dean III1,2, Jonathan O'Muircheartaigh3, Sara D'Arpino1, Holly Dirks1, and Sean C.L. Deoni1,4
1Advanced Baby Imaging Lab, School of Engineering, Brown University, Providence, RI, United States, 2Waisman Lab for Brain Imaging and Behavior, University of Wisconsin, Madison, WI, United States, 3Department of Neuroimaging, King's College London, Institute of Psychiatry, London, United Kingdom, 4Department of Pediatric Radiology, Children's Hospital Colorado, Aurora, CO, United States

The apolipoprotein (APOE) ε4 allele, a main risk factor for late onset Alzheimer’s Disease, has been associated with neurological differences in infants in cross-sectional studies. Longitudinal myelin growth curves, in 223 infants and children grouped according to APOE genotype, exhibited differential white matter development in neuroanatomical regions related to Alzheimer’s Disease. Group differences in overall cognition were also observed between APOE ε4 carriers and noncarriers. Results suggest the ε4 allele plays an important role in early neurodevelopment, with both anatomical and cognitive brain alterations seen several decades before disease symptoms commonly occur.

15:45   Imaging Dementias with MRI
Mykol Larvie, M.D., Ph.D.
16:15   Adjournment & Meet the Teachers