Schmidt R
Department of Neurology, Karl Franzens University Graz, Austria.
Eur Neurol. 1992;32(3):164-9. doi: 10.1159/000116816.
MRI scans of 27 patients with probable Alzheimer's disease (mean age 68.2 years), 31 patients with vascular dementia (mean age 69.9 years) and 18 normal controls (mean age 66.3 years) were compared to evaluate possible distinguishing parenchymal abnormalities among these groups. Atrophy was quantitated by subjective rating, linear and volumetric measurements. A number of findings were significantly more common in vascular dementia than in the other subsets. These included (1) basal ganglionic/thalamic hyperintense foci, (2) thromboembolic infarctions, (3) confluent white matter and (4) irregular periventricular hyperintensities. Signal abnormalities on intermediate T2-weighted scans in the uncal-hippocampal or insular cortex were frequently and almost exclusively noted in Alzheimer's disease. Moderate and severe cortical and ventricular atrophy and a third ventricular to intracranial width ratio larger than 7% were good discriminators between demented groups and normally aging controls. Selective atrophy measurements, however, failed to separate dementia syndromes. These results suggest that MRI has the potential to increase the accuracy of the clinical diagnosis of Alzheimer's disease and vascular dementia.
对27例可能患有阿尔茨海默病的患者（平均年龄68.2岁）、31例血管性痴呆患者（平均年龄69.9岁）和18名正常对照者（平均年龄66.3岁）进行了磁共振成像（MRI）扫描，以评估这些组之间可能存在的实质性异常差异。通过主观评分、线性测量和体积测量对萎缩情况进行定量分析。血管性痴呆组中一些发现明显比其他亚组更常见。这些发现包括：（1）基底节/丘脑高信号灶；（2）血栓栓塞性梗死；（3）融合性白质病变；（4）不规则的脑室周围高信号。在钩回-海马或岛叶皮质的中等T2加权扫描上的信号异常在阿尔茨海默病中经常且几乎仅能观察到。中度和重度皮质及脑室萎缩以及第三脑室与颅内宽度之比大于7%是区分痴呆组与正常老龄对照组的良好指标。然而，选择性萎缩测量未能区分痴呆综合征。这些结果表明，MRI有可能提高阿尔茨海默病和血管性痴呆临床诊断的准确性。
