Background and Purpose
The limitations inherent to the current methods of diagnosing Mild Cognitive Impairment (MCI) have constrained the use of early therapeutic interventions to delay the progression of MCI to dementia. This study evaluated whether quantifying enlarged perivascular spaces (EPVS) observed on MR imaging can help us differentiate MCI from cognitively healthy controls and, thus, have an application in the diagnosis of MCI.
Methods
We automated the identification of EPVS in brain MR Images using a custom quantitative program designed with MATLAB. We then quantified EPVS densities for MCI patients (n=14) and age-matched cognitively healthy controls (n=15), and compared them to determine if EPVS density can serve as an imaging surrogate for MCI diagnosis.
Results
Quantified as a percentage of volume fraction, EPVS densities were calculated to be 2.82±0.40 v/v% for the controls and 4.17±0.57 v/v% for the MCI group in the subcortical brain (p<0.0001), and 2.74±0.57 v/v% for the controls and 3.90±0.62 v/v% for the MCI cohort in the basal ganglia (p<0.0001). Maximum intensity projections exhibited a visually conspicuous difference in the EPVS distributions for an MCI and a control patient. Using ROC curve analysis, the sensitivity and the specificity for using EPVS as a differentiating biomarker between MCI and controls were determined to be 92.86% and 93.33% respectively.
Conclusion
EPVS density was found to be significantly higher in MCI compared to age-matched healthy control subjects. EPVS density, therefore, may be a useful imaging biomarker for the diagnosis of MCI.