Cavallin L, Axelsson R, Wahlund L O, Oksengard A R, Svensson L, Juhlin P, Wiberg M Kristoffersen, Frank A
Division of Radiology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Acta Radiol. 2008 Dec;49(10):1154-61. doi: 10.1080/02841850802438512.
Current diagnosis of Alzheimer disease is made by clinical, neuropsychologic, and neuroimaging assessments. Neuroimaging techniques such as magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) could be valuable in the differential diagnosis of Alzheimer disease, as well as in assessing prognosis.
To compare SPECT and MRI in a cohort of patients examined for suspected dementia, including patients with no objective cognitive impairment (control group), mild cognitive impairment (MCI), and Alzheimer disease (AD).
24 patients, eight with AD, 10 with MCI, and six controls, were investigated with SPECT using (99m)Tc-hexamethylpropyleneamine oxime (HMPAO, Ceretec; GE Healthcare Ltd., Little Chalsont UK) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with a contrast-enhancing gadobutrol formula (Gadovist; Bayer Schering Pharma, Berlin, Germany). Voxel-based correlation between coregistered SPECT and DSC-MR images was calculated. Region-of-interest (ROI) analyses were then performed in 24 different brain areas using brain registration and analysis of SPECT studies (BRASS; Nuclear Diagnostics AB, Stockholm, Sweden) on both SPECT and DSC-MRI.
Voxel-based correlation between coregistered SPECT and DSC-MR showed a high correlation, with a mean correlation coefficient of 0.94. ROI analyses of 24 regions showed significant differences between the control group and AD patients in 10 regions using SPECT and five regions in DSC-MR.
SPECT remains superior to DSC-MRI in differentiating normal from pathological perfusion, and DSC-MRI could not replace SPECT in the diagnosis of patients with Alzheimer disease.
目前阿尔茨海默病的诊断是通过临床、神经心理学和神经影像学评估来进行的。磁共振成像（MRI）和单光子发射计算机断层扫描（SPECT）等神经影像学技术在阿尔茨海默病的鉴别诊断以及评估预后方面可能具有重要价值。
在一组因疑似痴呆而接受检查的患者中比较SPECT和MRI，这些患者包括无客观认知障碍的患者（对照组）、轻度认知障碍（MCI）患者和阿尔茨海默病（AD）患者。
对24例患者进行了研究，其中8例为AD患者，10例为MCI患者，6例为对照组。使用（99m）锝-六甲基丙烯胺肟（HMPAO，Ceretec；通用电气医疗集团有限公司，英国小查尔森特）对患者进行SPECT检查，并使用含钆布醇配方（Gadovist；拜耳先灵医药公司，德国柏林）的动态磁敏感对比磁共振成像（DSC-MRI）。计算配准后的SPECT和DSC-MR图像之间基于体素的相关性。然后使用SPECT和DSC-MRI的脑配准和SPECT研究分析（BRASS；瑞典斯德哥尔摩核诊断公司）在24个不同脑区进行感兴趣区（ROI）分析。
配准后的SPECT和DSC-MR之间基于体素的相关性显示出高度相关性，平均相关系数为0.94。对24个区域的ROI分析显示，对照组与AD患者之间在使用SPECT的10个区域以及使用DSC-MR的5个区域存在显著差异。
在区分正常灌注与病理灌注方面，SPECT仍然优于DSC-MRI，并且在阿尔茨海默病患者的诊断中，DSC-MRI无法替代SPECT。
