Streitparth F, Wieners G, Kämena A, Schröder R J, Stiepani H, Kokocinski T, Röttgen R, Steinhagen-Thiessen E, Lenzen-Grossimlimghaus R, Hidajat N
Klinik für Strahlenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 , Berlin.
Radiologe. 2008 Feb;48(2):175-83. doi: 10.1007/s00117-006-1443-y.
The diagnostic value of perfusion CT in dementia patients was retrospectively evaluated in comparison to the Mini-Mental State Examination (MMSE).
The perfusion CT database of 55 subjects was investigated. All patients underwent an unenhanced, contrast-enhanced, and perfusion CT of the head. The clinical evaluation of the degree of dementia was performed with the MMSE. In the perfusion CT data, 24 ROI were marked. Then blood volume (BV), blood flow (BF), and mean transit time (MTT) were calculated and compared with the ipsilateral and contralateral regions and with the degree of dementia.
With increasing degree of dementia, a significant decrease of the occipital and temporal BV was found. A significant decrease of the BF in the frontal lobe, basal ganglia, and occipital region was found. Concurrently, the MTT increased significantly in the basal ganglia region. The group with Alzheimer's disease showed significant regional hypoperfusion compared with the group of cognitively normal subjects in the frontal, basal ganglia, occipital, and temporal region.
The cerebral perfusion decreased with increasing degree of dementia. The inexpensive and widely available perfusion CT reveals information about regional differences of cerebral perfusion, which may be useful in differentiating severity and types of dementia.
与简易精神状态检查表（MMSE）相比，回顾性评估灌注CT在痴呆患者中的诊断价值。
研究了55名受试者的灌注CT数据库。所有患者均接受了头部的平扫、增强扫描和灌注CT检查。采用MMSE对痴呆程度进行临床评估。在灌注CT数据中，标记了24个感兴趣区（ROI）。然后计算血容量（BV）、血流（BF）和平均通过时间（MTT），并与同侧和对侧区域以及痴呆程度进行比较。
随着痴呆程度的增加，枕叶和颞叶的BV显著降低。额叶、基底节和枕叶区域的BF显著降低。同时，基底节区域的MTT显著增加。与认知正常受试者组相比，阿尔茨海默病组在额叶、基底节、枕叶和颞叶区域存在明显的局部灌注不足。
随着痴呆程度的增加，脑灌注减少。价格低廉且广泛应用的灌注CT可揭示脑灌注的区域差异信息，这可能有助于区分痴呆的严重程度和类型。
