Hanyu H, Nakano S, Abe S, Arai H, Iwamoto T, Takasaki M
Department of Geriatric Medicine, Tokyo Medical College.
Nihon Ronen Igakkai Zasshi. 1994 Sep;31(9):683-9. doi: 10.3143/geriatrics.31.683.
We sought to identify a marker for Alzheimer's disease (AD) for antemortem diagnosis. To determine whether the detection of reduced blood flow in the parietotemporal cortex, shown by single photon emission CT (SPECT), and of medial temporal lobe atrophy, shown by magnetic resonance imaging (MRI), would be useful in diagnosis, we studied 38 patients with AD diagnosed by the NINCDS-ADRDA criteria and 26 healthy elderly controls. Parietotemporal hypoperfusion was qualitatively assessed by physicians who were unaware of the clinical diagnosis, and the severity of medial temporal lobe atrophy was quantitated by planimetric and linear measurements. Although an accurate diagnosis of AD was made in 80% or more of the patients by SPECT or MRI studies alone, the combination of SPECT and MRI gave a higher diagnostic accuracy, with a sensitivity of 95% and a specificity of 92%. Since regional functional or structural changes were detected in 92% of early or mild patients, including possible AD, the combination of SPECT and MRI studies were useful in the early diagnosis of AD. Findings suggest that a functional abnormality in the parietotemporal lobe and an atrophic change in the medial temporal lobe are characteristic of AD, and that SPECT and MIR regional changes may be useful as antemortem diagnostic markers.
我们试图寻找一种用于阿尔茨海默病（AD）生前诊断的标志物。为了确定单光子发射计算机断层扫描（SPECT）显示的顶颞叶皮质血流减少以及磁共振成像（MRI）显示的内侧颞叶萎缩的检测是否有助于诊断，我们研究了38例根据NINCDS - ADRDA标准诊断为AD的患者和26名健康老年对照。由不知道临床诊断结果的医生对顶颞叶灌注不足进行定性评估，通过面积测量和线性测量对内侧颞叶萎缩的严重程度进行定量分析。尽管仅通过SPECT或MRI研究就能在80%或更多的患者中准确诊断出AD，但SPECT和MRI联合使用具有更高的诊断准确性，敏感性为95%，特异性为92%。由于在92%的早期或轻度患者（包括可能患有AD的患者）中检测到了区域性功能或结构变化，SPECT和MRI研究联合使用有助于AD的早期诊断。研究结果表明，顶颞叶的功能异常和内侧颞叶的萎缩性变化是AD的特征，并且SPECT和MRI的区域变化可能作为生前诊断标志物有用。
