Caroli Anna, Frisoni Giovanni B
LENITEM Laboratory of Epidemiology, Neuroimaging, and Telemedicine - IRCCS S. Giovanni di Dio-FBF, Brescia, Italy.
Expert Rev Med Devices. 2009 Sep;6(5):569-88. doi: 10.1586/erd.09.35.
Alzheimer's disease (AD) can be definitively diagnosed only by histopathologic examination of brain tissue; the identification and differential diagnosis of AD is especially challenging in its early stages. Neuroimaging is playing an increasingly relevant role in the identification and quantification of AD in vivo, especially in the preclinical stages, when therapeutic intervention could be more effective. Neuroimaging enables quantification of brain volume loss (structural imaging), detection of early cerebral dysfunction (functional imaging), probing into the finest cerebral structures (microstructural imaging), and investigation of amyloid plaque and neurofibrillary tangle build-up (amyloid imaging). Throughout the years, several imaging tools have been developed, ranging from simple visual rating scales to sophisticated computerized algorithms. As recently revised criteria for AD require quantitative evaluation of biomarkers mostly based on imaging, this paper provides an overview of the main neuroimaging tools which might be used presently or in the future in routine clinical practice for AD diagnosis.
阿尔茨海默病（AD）只有通过脑组织的组织病理学检查才能明确诊断；AD的识别和鉴别诊断在其早期阶段尤其具有挑战性。神经影像学在AD的体内识别和定量方面发挥着越来越重要的作用，特别是在临床前阶段，此时进行治疗干预可能会更有效。神经影像学能够对脑容量损失进行定量（结构成像）、检测早期脑功能障碍（功能成像）、探究最精细的脑结构（微观结构成像）以及研究淀粉样斑块和神经原纤维缠结的形成（淀粉样成像）。多年来，已经开发了多种成像工具，从简单的视觉评分量表到复杂的计算机算法。由于最近修订的AD标准大多要求基于成像对生物标志物进行定量评估，本文概述了目前或未来可能在AD诊断的常规临床实践中使用的主要神经影像学工具。
