Mendez M F, Mastri A R, Zander B A, Frey W H
Department of Neurology, St. Paul-Ramsey Medical Center, MN 55101.
J Am Geriatr Soc. 1992 May;40(5):476-8. doi: 10.1111/j.1532-5415.1992.tb02014.x.
To investigate the accuracy of cranial computerized tomography (CT) scans in distinguishing patients with Alzheimer's disease from those with other dementing conditions.
Retrospective clinicopathological correlation with pre-mortem CT scans.
Urban and rural hospitals and nursing homes in the Upper Midwest.
All 507 patients had clinical dementia diagnosed as Alzheimer's disease during life and the subsequent referral of their brains to a dementia brain bank. Of these, 375 patients had had CT scans as part of the diagnostic work-up for dementia.
The presence of neuropathological evidence of Alzheimer's disease and the specific findings on CT scans.
Of the 375 patients evaluated with a CT, 28% were misdiagnosed (lacked neuropathological evidence of Alzheimer's disease); of the 132 patients evaluated without a CT scan, only 18% were misdiagnosed (P less than 0.05). The degree of atrophy and other CT findings were similar in the correctly diagnosed and misdiagnosed groups except for increased ventricular size in the correctly diagnosed patients (P less than 0.05).
Although CT scans do not usually contribute to the recognition of Alzheimer's disease, the presence of ventricular enlargement may help distinguish Alzheimer's disease from other dementias.
研究头颅计算机断层扫描（CT）在区分阿尔茨海默病患者与其他痴呆症患者方面的准确性。
对生前CT扫描进行回顾性临床病理相关性研究。
中西部上区的城乡医院及养老院。
所有507例患者生前临床诊断为痴呆症，诊断为阿尔茨海默病，随后其大脑被转诊至痴呆症脑库。其中，375例患者进行了CT扫描，作为痴呆症诊断检查的一部分。
阿尔茨海默病神经病理学证据的存在情况以及CT扫描的具体结果。
在接受CT评估的375例患者中，28%被误诊（缺乏阿尔茨海默病的神经病理学证据）；在未进行CT扫描的132例患者中，只有18%被误诊（P<0.05）。除了正确诊断的患者脑室增大外（P<0.05），正确诊断组和误诊组的萎缩程度及其他CT表现相似。
虽然CT扫描通常无助于识别阿尔茨海默病，但脑室扩大可能有助于将阿尔茨海默病与其他痴呆症区分开来。
