Høgh Peter, Teller Ann-Sofie, Hasselbalch Steen, Waldemar Gunhild
Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Neuroscience Centre, Copenhagen, Denmark.
Dement Geriatr Cogn Disord. 2007;24(6):429-33. doi: 10.1159/000110023. Epub 2007 Oct 19.
The aim of this study was to assess the accuracy of visual image rating as compared to parametric analysis of regional cerebral blood flow (rCBF) measured with SPECT in patients referred to a memory clinic for diagnostic evaluation of cognitive symptoms.
SPECT with (99m)Tc-HMPAO was used to determine rCBF in 47 patients and 26 healthy control subjects. The 47 patients (30 F/17 M) had a mean age of 74.6 years (range = 62-88) and mild or questionable dementia with an MMSE score of 24.8 (range = 20-30). Two experienced image readers blinded to the classifications and identity of subjects performed visual rating in consensus and the global and regional CBF patterns were evaluated and graded according to severity of hypoperfusion. Correlation coefficients were calculated using results from the parametric analyses as gold standard.
The sensitivity and specificity of global visual rating (normal vs. abnormal SPECT) was 92 and 86%, respectively, yielding an overall accuracy of 89% for visual rating compared to parametric analysis. The correlation between visual rating and parametric analysis was highly significant (p < 0.001).
Visual rating is a valid method for analyzing SPECT images in patients with mild or questionable dementia.
本研究旨在评估在转诊至记忆门诊进行认知症状诊断评估的患者中，视觉图像评分与用单光子发射计算机断层扫描（SPECT）测量的局部脑血流量（rCBF）参数分析相比的准确性。
对47例患者和26名健康对照者使用（99m）锝-六甲基丙烯胺肟（Tc-HMPAO）SPECT来测定rCBF。47例患者（30例女性/17例男性）的平均年龄为74.6岁（范围=62-88岁），患有轻度或可疑痴呆，简易精神状态检查表（MMSE）评分为24.8（范围=20-30）。两名对受试者分类和身份不知情的经验丰富的图像阅片者进行了一致的视觉评分，并根据灌注不足的严重程度对整体和局部CBF模式进行了评估和分级。使用参数分析结果作为金标准计算相关系数。
整体视觉评分（正常与异常SPECT）的敏感性和特异性分别为92%和86%，与参数分析相比，视觉评分的总体准确率为89%。视觉评分与参数分析之间的相关性非常显著（p<0.001）。
视觉评分是分析轻度或可疑痴呆患者SPECT图像的有效方法。
