Lehéricy S, Baulac M, Chiras J, Piérot L, Martin N, Pillon B, Deweer B, Dubois B, Marsault C
INSERM U289, Hôpital de la Pitié-Salpêtrière, Paris, France.
AJNR Am J Neuroradiol. 1994 May;15(5):929-37.
To evaluate the accuracy of hippocampal and amygdala volume measurements in diagnosing patients in the early stages of Alzheimer disease.
Measurements of the hippocampal formation, amygdala, amygdalohippocampal complex (the two measurements summed), caudate nucleus, and ventricles, normalized for total intracranial volume, were obtained on coronal sections (1.5 T, 400/13 [repetition time/echo time], 5 mm) of 13 patients in the mild (minimental status > or = 21) and five patients in the moderate stages of Alzheimer disease (10 < minimental status < 21), and eight age-matched control subjects.
For patients with a minimental status score of 21 or greater, atrophy was significant for the amygdala and hippocampal formation (-36% and -25% for amygdala/total intracranial volume and hippocampal formation/total intracranial volume, respectively), but not for the caudate nucleus. No significant ventricular enlargement was found. For patients with a minimental status score less than 21, atrophy was more severe in all structures studied (amygdala/total intracranial volume, -40%; hippocampal formation/total intracranial volume, -45%; caudate nucleus/total intracranial volume, -21%), and ventricles were enlarged (63%). No overlap was found between Alzheimer disease and control values for the amygdalohippocampal volume, even in the mild stages of the disease. In Alzheimer disease patients, hippocampal formation volumes correlated with the minimental status.
Hippocampal and amygdala atrophy is marked and significant in the mild stages of Alzheimer disease. Volumetric measurements of the amygdala and the amygdalohippocampal complex appear more accurate than those of the hippocampal formation alone in distinguishing patients with Alzheimer disease.
评估海马体和杏仁核体积测量在诊断早期阿尔茨海默病患者中的准确性。
在13例轻度（简易精神状态评分≥21）和5例中度（10＜简易精神状态评分＜21）阿尔茨海默病患者以及8名年龄匹配的对照受试者的冠状位切片（1.5T，400/13[重复时间/回波时间]，5mm）上，测量海马结构、杏仁核、杏仁核 - 海马复合体（两项测量值相加）、尾状核和脑室，并将其颅内总体积标准化。
简易精神状态评分为21分或更高的患者，杏仁核和海马结构萎缩显著（杏仁核/颅内总体积和海马结构/颅内总体积分别为 - 36%和 - 25%），但尾状核无萎缩。未发现脑室显著扩大。简易精神状态评分低于21分的患者，所有研究结构的萎缩更严重（杏仁核/颅内总体积， - 40%；海马结构/颅内总体积， - 45%；尾状核/颅内总体积， - 21%），且脑室扩大（63%）。即使在疾病的轻度阶段，阿尔茨海默病与对照值在杏仁核 - 海马体积方面也没有重叠。在阿尔茨海默病患者中，海马结构体积与简易精神状态评分相关。
在阿尔茨海默病的轻度阶段，海马体和杏仁核萎缩明显且显著。杏仁核和杏仁核 - 海马复合体的体积测量在区分阿尔茨海默病患者方面似乎比单独测量海马结构更准确。
