Ishii Kenji
Nihon Rinsho. 2014 Apr;72(4):681-6.
The role of neuroimaging in the diagnosis of dementia diseases is overviewed. In the clinical practice, screening imaging examinations such as X-ray CT and MRI of the brain are useful to exclude cerebrovascular disorders, brain tumors, subdural hematomas, and normal pressure hydrocephalus from neurodegenerative disorders. After differentiating those disorders, the regional distribution patterns of atrophy, neuronal injury, or functional impairment detected by morphological MRI, perfusion SPECT, or 18F-FDG PET are useful for the differential diagnosis of neurodegenerative diseases. Cardiac scintigraphy by 123I- MIBG, dopamine transporter imaging, and amyloid imaging give us pathology specific information such as cardiac autonomic dysfunction mainly by Lewy body disease, nigral degeneration with parkinson's syndrome, and amyloid deposition with Alzheimer's disease. Those structural, functional, and pathology specific neuroimaging tools can be used not only for the early diagnosis, but also for tracing disease progression in understanding the relationship between life style diseases and dementia, and developing disease modifying therapies.
本文综述了神经影像学在痴呆症诊断中的作用。在临床实践中,诸如脑部X线CT和MRI等筛查性影像学检查有助于排除脑血管疾病、脑肿瘤、硬膜下血肿和正常压力脑积水等非神经退行性疾病。在鉴别出这些疾病后,通过形态学MRI、灌注SPECT或18F-FDG PET检测到的萎缩、神经元损伤或功能损害的区域分布模式,对于神经退行性疾病的鉴别诊断很有用。123I-MIBG心肌闪烁显像、多巴胺转运体成像和淀粉样蛋白成像为我们提供了病理学特异性信息,例如主要由路易体病导致的心脏自主神经功能障碍、帕金森综合征伴黑质变性以及阿尔茨海默病伴淀粉样蛋白沉积。这些结构、功能和病理学特异性神经影像学工具不仅可用于早期诊断,还可用于追踪疾病进展,以了解生活方式疾病与痴呆症之间的关系,并开发疾病修饰疗法。