通过脑灌注 SPECT 对路易体痴呆和阿尔茨海默病进行鉴别诊断的新方法的发展——与 CIScore 的比较。
The development of new method to differentiate between Dementia with Lewy bodies and Alzheimer's disease by cerebral perfusion SPECT-comparison to CIScore.
机构信息
Department of Radiology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Department of Psychiatry, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
出版信息
Jpn J Radiol. 2021 Feb;39(2):198-205. doi: 10.1007/s11604-020-01041-0. Epub 2020 Sep 16.
PURPOSE
The Cingulate Island Sign score (CIScore) by rCBF SPECT is used in the differentiation between Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) but has some false-positive AD cases. To resolve the problem, we developed new differential diagnosing method incorporating occipital lobe and para-hippocampal rCBF.
MATERIALS AND METHODS
In 27 DLB and 31 AD cases undertaken Tc-99 m-ECD SPECT, we evaluated the mean Z score in the bilateral superior, middle, inferior occipital gyri, cuneus, amygdala, hippocampus, and para-hippocampus. One criterion of DLB was defined as the case with CIScore lower than 0.27. The other criteria were the cases of following either or both two conditions were satisfied. (1) The number of occipital gyri with mean Z score higher than 1 is three or more. (2) The number of hippocampal regions with mean Z score higher than 1 is one or less. We compared the differential diagnostic ability among these four criterions.
RESULTS
The diagnostic accuracy by CIscore was 69% and that of the occipital gyri analysis 84%, para-hippocampal regions analysis 76% and combined occipital gyri and para-hippocampal regions analysis 93%.
CONCLUSION
The new method by combined rCBF analysis of occipital gyri and para-hippocampal regions showed best diagnostic ability in differentiating DLB from AD.
目的
脑血流量 SPECT 的扣带回岛征评分（CIScore）用于鉴别路易体痴呆（DLB）和阿尔茨海默病（AD），但存在一些 AD 的假阳性病例。为了解决这个问题，我们开发了一种新的鉴别诊断方法，纳入了枕叶和海马旁回的 rCBF。
材料和方法
在 27 例 DLB 和 31 例 AD 患者中进行了 Tc-99m-ECD SPECT，我们评估了双侧顶叶、中颞叶、下回、楔叶、杏仁核、海马和海马旁回的平均 Z 评分。DLB 的一个标准是 CIScore 低于 0.27。另一个标准是满足以下两种情况之一或两者都满足的病例。（1）有 3 个或更多枕叶的平均 Z 评分高于 1。（2）有 1 个或更少的海马区的平均 Z 评分高于 1。我们比较了这四个标准的鉴别诊断能力。
结果
CIscore 的诊断准确性为 69%，枕叶分析为 84%，海马旁回区域分析为 76%，枕叶和海马旁回区域联合分析为 93%。
结论
枕叶和海马旁回 rCBF 联合分析的新方法在鉴别 DLB 和 AD 方面显示出最佳的诊断能力。
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