O'Brien J T, Metcalfe S, Swann A, Hobson J, Jobst K, Ballard C, McKeith I, Gholkar A
Institute for the Health of the Elderly, University of Newcastle-upon-Tyne, Glasgow, UK. j.t.o'
Dement Geriatr Cogn Disord. 2000 Mar-Apr;11(2):114-8. doi: 10.1159/000017223.
A simple linear measurement of the minimum width of the medial temporal lobe (MTL) on angled CT scans has been suggested as an accurate ante-mortem marker for Alzheimer's disease (AD). To determine the clinical utility and specificity of this finding, we performed angled CT scans with 5-mm slices in 116 subjects referred to a geographically based Old Age Psychiatry service in Newcastle. Diagnoses were of NINCDS/ADRDA AD (n = 69, 36 probable and 33 possible). NINDS/AIREN vascular dementia (VaD, n = 25), consensus criteria for dementia with Lewy bodies (DLB, n = 9) and DSM-IV criteria for major depression (n = 13). Subjects were well matched for age. Minimum MTL width was significantly greater in depressed subjects (13.7 mm) compared to those with dementia, though no differences were seen within the dementia groups (AD 10.8, VaD 10.4, and DLB 10.9 mm). An MTL width below 11.5 mm had a sensitivity of 54% (56/103) and a specificity of 77% (10/13) for distinguishing dementia from depression. We conclude that a single cross-sectional measurement of MTL width on CT does not help differentiate between different types of dementia, though it may provide some supportive evidence when distinguishing depression from dementia.
有人提出，在有角度的CT扫描上对内侧颞叶（MTL）最小宽度进行简单的线性测量，可作为阿尔茨海默病（AD）准确的生前标志物。为了确定这一发现的临床实用性和特异性，我们对116名转诊至纽卡斯尔一家基于地理位置的老年精神病服务机构的受试者进行了层厚为5毫米的有角度CT扫描。诊断包括NINCDS/ADRDA标准的AD（n = 69，36例可能病例和33例疑似病例）、NINDS/AIREN标准的血管性痴呆（VaD，n = 25）、路易体痴呆共识标准（DLB，n = 9）以及DSM-IV标准的重度抑郁症（n = 13）。受试者在年龄上匹配良好。与痴呆患者相比，抑郁症患者的MTL最小宽度（13.7毫米）显著更大，不过在各痴呆组之间未观察到差异（AD为10.8毫米，VaD为10.4毫米，DLB为10.9毫米）。MTL宽度低于11.5毫米用于区分痴呆和抑郁症时，敏感性为54%（56/103），特异性为77%（10/13）。我们得出结论，CT上MTL宽度的单次横断面测量无助于区分不同类型的痴呆，不过在区分抑郁症和痴呆时可能提供一些支持性证据。
