Laakso M, Soininen H, Partanen K, Hallikainen M, Lehtovirta M, Hänninen T, Vainio P, Riekkinen P J
Department of Neurology, University Hospital, Finland.
AJNR Am J Neuroradiol. 1995 Apr;16(4):727-34.
To examine the value of measurement of the interuncal distance in the diagnosis of mild to moderate Alzheimer disease.
We measured interuncal distance from coronal MR scans acquired on a 1.5-T imager. We estimated interuncal distance from a total of 141 subjects: 54 patients diagnosed according to the National Institute of Neurological and Communicative Disorders and the Alzheimer's Disease and Related Disorders Association criteria of probable Alzheimer disease, 40 subjects fulfilling the National Institute of Mental Health criteria of age-associated memory impairment, 27 healthy cognitively normal older control subjects, and 20 control subjects younger than 50 years of age. For comparison we normalized interuncal distance for a horizontal line drawn through the inner cranium at the level of the uncus (interuncal distance/intracranial width ratio), for the brain area (interuncal distance/brain area) and for the intracranial area (interuncal distance/intracranial area).
The standard interuncal distance and the interuncal distance/intracranial width differed between the young control subjects and the other groups, but did not differ among the control, age-associated memory impairment, and Alzheimer disease groups. The Alzheimer disease group had significantly greater interuncal distance/intracranial area and interuncal distance/brain area compared with age-matched controls. A considerable overlap was found, however, in the values of patients with Alzheimer disease and control subjects. The cutoff point of 30 mm for interuncal distance yielded 37% sensitivity and 72% specificity to distinguish patients with Alzheimer disease from nondemented elderly subjects. Interuncal distance was not significantly related to the clinical severity of Alzheimer disease as assessed by Clinical Dementia Rating Scale and Mini-Mental Status Examination. Instead, there was a strong correlation between standard and normalized interuncal distance and age in the whole study population and in nondemented subjects.
Our results showed that in a series of 54 patients with mild to moderate Alzheimer disease, interuncal distance was not a reliable diagnostic tool. The study also confirmed the strong age dependence for interuncal distance.
探讨测量大脑脚间距在轻至中度阿尔茨海默病诊断中的价值。
我们从在1.5-T成像仪上获取的冠状位磁共振扫描图像中测量大脑脚间距。我们对总共141名受试者的大脑脚间距进行了评估：54名根据美国国立神经疾病与中风研究所及阿尔茨海默病及相关疾病协会可能的阿尔茨海默病标准确诊的患者，40名符合美国国立精神卫生研究所年龄相关性记忆障碍标准的受试者，27名认知功能正常的健康老年对照受试者，以及20名年龄小于50岁的对照受试者。为了进行比较，我们将大脑脚间距相对于在钩回水平穿过颅骨内部的一条水平线进行标准化（大脑脚间距/颅内宽度比），相对于脑区（大脑脚间距/脑区）以及相对于颅内面积（大脑脚间距/颅内面积）。
年轻对照受试者与其他组之间的标准大脑脚间距及大脑脚间距/颅内宽度存在差异，但在对照、年龄相关性记忆障碍及阿尔茨海默病组之间无差异。与年龄匹配的对照组相比，阿尔茨海默病组的大脑脚间距/颅内面积及大脑脚间距/脑区显著更大。然而，发现阿尔茨海默病患者与对照受试者的值有相当大的重叠。大脑脚间距为30 mm的截断点在区分阿尔茨海默病患者与非痴呆老年受试者时，敏感性为37%，特异性为72%。大脑脚间距与通过临床痴呆评定量表和简易精神状态检查评估的阿尔茨海默病临床严重程度无显著相关性。相反，在整个研究人群及非痴呆受试者中，标准大脑脚间距和标准化大脑脚间距与年龄之间存在很强的相关性。
我们的结果表明，在54名轻至中度阿尔茨海默病患者中，大脑脚间距不是一种可靠的诊断工具。该研究还证实了大脑脚间距对年龄的强烈依赖性。
