Leys D, Steinling M, Petit H, Salomez J L, Gaudet Y, Ovelacq E, Vergnes R
Service de neurologie, C.H.U. de Lille.
Rev Neurol (Paris). 1989;145(6-7):443-50.
Single photon emission tomography with Hm PAO Tc99m was used in 27 patients with probable Alzheimer's disease, 9 patients with multi-infarct, dementia, and 11 healthy volunteers. The data were quantified in 4 regions of interest (using the basal ganglia as an internal standard): left and right prefrontal areas (Fg and Fd), and left and right parietal areas (Pg and Pd). Pg and Pd indices were lower in patients with Alzheimer's disease than in patients with multi-infarct dementia, and healthy volunteers (p less than 0.05). The ratio (Fd + Pd)/(Fg + Pg) was lower in patients with dressing apraxia (p less than 0.02), anosognosia (p less than 0.001), spatial agnosia (p less than 0.01), ideomotor apraxia (p less than 0.02), ideatory apraxia (p less than 0.01), and constructive apraxia (p less than 0.01). No correlation could be established between this ratio and the severity of aphasia, or between the indices and mini mental state scores. With Pg and Pd indices lower than 0.90, sensitivity for Alzheimer's disease was 70 p. 100 and specificity, 75 p. 100.
采用锝-99m六甲基丙烯胺肟单光子发射断层扫描对27例疑似阿尔茨海默病患者、9例多发梗死性痴呆患者及11名健康志愿者进行了检查。在4个感兴趣区(以基底神经节作为内标)对数据进行了量化:左右前额叶区域(额上回和额下回)以及左右顶叶区域(顶上小叶和顶下小叶)。阿尔茨海默病患者的顶上小叶和顶下小叶指数低于多发梗死性痴呆患者及健康志愿者(p<0.05)。穿衣失用症患者(p<0.02)、疾病感缺失患者(p<0.001)、空间失认症患者(p<0.01)、观念运动性失用症患者(p<0.02)、观念性失用症患者(p<0.01)和结构性失用症患者(p<0.01)的(额下回 + 顶下小叶)/(额上回 + 顶上小叶)比值较低。该比值与失语症严重程度之间以及这些指数与简易精神状态评分之间均未发现相关性。当顶上小叶和顶下小叶指数低于0.90时,阿尔茨海默病的敏感性为70%,特异性为75%。