目的：研究动脉自旋标记 MRI（ASL-MRI）灌注成像技术在诊断和区分早老年痴呆患者中的应 用。方法：选取13例阿尔兹海默病（AD）患者（AD组）和18例额颞叶痴呆（FTD）患者（FTD组），24例年 龄匹配的老年对照者（老年对照组）和 22 例青年对照者（青年对照组）。所有受试者接受 ASL-MRI 检 测。对10个灰质区域的脑血流量和灰质体积进行定量分析，并开展敏感性、特异性和诊断性能评估。结 果：与老年对照组相比，FTD组前扣带回皮质灌注不足，AD组出现更广泛的局部灌注不足和萎缩。与FTD 组相比，AD组的后扣带回皮质灌注不足。AD和FTD的鉴别灵敏度为68%，特异度为67%。AD与对照 组的鉴别诊断灵敏度为76%，特异度为75%；FTD与对照组的鉴别诊断灵敏度为78%，特异度为74%。相 比青年对照组，老年对照组呈现脑血流灌注不足。结论：ASL-MRI有助于早老性AD和FTD的早期诊断 和鉴别。前扣带回皮质和后扣带回皮质灌注不足可作为鉴别早老性AD、FTD的定量诊断标记。

To explore the application of arterial spin labeling magnetic resonance imaging (ASL-MRI) in the diagnosis and differentiation of presenile dementia. Methods: Total 13 patients with Alzheimer’s disease (AD) and 18 patients with frontotemporal dementia (FTD) were enrolled and assigned to the AD group and FTD group, respectively; 24 aged matched healthy elderly subjects and 22 healthy young subjects were enrolled and respectively assigned to the old control group and young control group. All subjects underwent ASL-MRI to quantify and analyze the cerebral blood flow (CBF) and volume of 10 gray matter regions. Sensitivity, specificity, and diagnostic performance assessments were performed in patients or patient groups and control groups with significant differences in cerebral blood flow. Results: Compared with that of the old control group, the perfusion of the anterior cingulate cortex in the FTD group was insufficient, and the AD group showed more extensive local hypo-perfusion and atrophy. Compared with that of the FTD group, perfusion of the posterior cingulate cortex in the AD group was insufficient. The differential sensitivity and specificity of the AD and FTD groups was 68% and 67% respectively; the differential diagnostic sensitivity and specificity of the AD and control groups was 76% and 75% respectively and that of the FTD and control groups was 78% and 74% respectively. Compared with the young control group, the old control group showed cerebral hypo-perfusion. Conclusion: ASL-MRI is helpful for the early diagnosis and differentiation of AD and FTD. Hypo-perfusion of the anterior cingulate cortex and posterior cingulate cortex can be used as a quantitative diagnostic marker for the diagnosis of Alzheimer's dementia and frontotemporal dementia.