THE VALUE OF QUANTITATIVE MRI METHODS (DIFFUSION TENSOR IMAGING) IN THE EARLY DIAGNOSIS OF THE PRECLINICAL STAGE OF BINSWANGER'S DISEASE
Keywords:
Binswanger's disease, vascular cognitive impairment, diffusion tensor imaging, fractional anisotropy, leukoaraiosis, early diagnosisAbstract
Objective:To study the diagnostic significance of quantitative indices of diffusion tensor imaging (DTI) for detecting microstructural changes in white matter at the preclinical stage of BD.
Relevance. Binswanger's disease (BD) is accompanied by progressive cognitive decline. Standard MRI (T1/T2 modes) reveals white matter changes (leukoaraiosis) only at late stages, when treatment is already ineffective.
Materials and Methods. The study involved 60 patients (55–70 years old) with arterial hypertension and cognitive complaints but without dementia. All underwent standard MRI and DTI tractography, analyzing fractional anisotropy (FA) and mean diffusivity (MD). Results. In most patients, standard MRI showed minimal changes; however, DTI revealed a statistically significant decrease in FA and an increase in MD in the frontal lobes and internal capsule. These changes correlated with impaired executive functions during neuropsychological testing.
Conclusion. DTI is a highly sensitive method that allows for the diagnosis of preclinical white matter disorganization. The use of DTI metrics reveals BD before the formation of pronounced leukoaraiosis, opening opportunities for timely therapy.
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