Berman K F, Weinberger D R
Psychiatr Clin North Am. 1984 Sep;7(3):487-501.
This article explored methods of brain imaging as they relate to the practice of psychiatry. In particular, technical aspects and clinical applications of CAT scanning are reviewed, and some neurologic conditions that may masquerade as psychiatric illness are considered. Suggested guidelines for CAT scanning in psychiatric patients are put forth, and implications of recent research findings in psychiatric disorders are discussed. In closing, we offer the following caveat: As "psychiatric" symptoms may be the earliest sign of structural CNS disease, the psychiatrist may be the first physician to evaluate patients with neurologic abnormalities. Because even the neurologic consultant may not be alert to the possibility of psychiatric symptoms alone heralding CNS pathology, the decision to augment the clinical impression with neuroradiologic or other brain imaging adjuncts (and to choose among them) may rest solely with the psychiatrist. Of these adjuncts, CAT scanning is almost always the most conclusive and reliable.
本文探讨了与精神病学实践相关的脑成像方法。特别回顾了计算机断层扫描(CAT扫描)的技术方面和临床应用,并考虑了一些可能伪装成精神疾病的神经系统疾病。提出了针对精神病患者进行CAT扫描的建议指南,并讨论了近期精神病学障碍研究结果的影响。最后,我们提出以下告诫:由于“精神”症状可能是中枢神经系统(CNS)结构性疾病的最早迹象,精神科医生可能是首位评估有神经系统异常患者的医生。因为即使是神经科会诊医生也可能没有意识到仅精神症状预示CNS病理学的可能性,所以决定是否用神经放射学或其他脑成像辅助手段(以及在它们之间进行选择)来强化临床印象可能完全取决于精神科医生。在这些辅助手段中,CAT扫描几乎总是最具决定性和可靠性的。