Becker T, Retz W, Hofmann E, Becker G, Teichmann E, Gsell W
Department of Psychiatry, University of Würzburg, Federal Republic of Germany.
J Neural Transm Gen Sect. 1995;99(1-3):7-54. doi: 10.1007/BF01271468.
An outline is given of some of the methodological issues discussed in neuroradiological research on psychiatric illness. Strengths and shortcomings of magnetic resonance imaging (MRI) in depicting and quantifying brain structures are described. Temporal lobe anatomy and pathology are easily accessible to MRI, whereas limits on anatomical delineation hamper approaches to frontal lobe study. White matter hyperintense lesions are sensitively depicted by MRI, but specificity is limited. Distinction of vascular and primary degenerative dementia is considerably improved by CT and MRI analysis. Computed tomography (CT) and MRI have enhanced the understanding of treatable organic psychiatric disorders, e.g., normal pressure hydrocephalus. Subcortical and white matter pathology has been replicated in CT and MRI studies of late-onset psychiatric disorders, clinical overlap with cerebrovascular disease or neurodegeneration may be of import. Transcranial sonography findings of brainstem structural change specific to unipolar depression may contribute to the understanding of affective psychoses. Magnetic resonance spectroscopy and functional MRI are likely to stimulate psychiatric research in the future.
本文概述了神经放射学对精神疾病研究中所讨论的一些方法学问题。描述了磁共振成像（MRI）在描绘和量化脑结构方面的优点和缺点。MRI很容易观察到颞叶的解剖结构和病理情况，而在额叶研究中，解剖结构描绘的局限性阻碍了相关研究进展。MRI能敏感地显示白质高信号病变，但特异性有限。通过CT和MRI分析，血管性痴呆和原发性退行性痴呆的鉴别有了显著改善。计算机断层扫描（CT）和MRI增进了对可治疗的器质性精神障碍（如正常压力脑积水）的理解。在迟发性精神障碍的CT和MRI研究中已重现了皮质下和白质病变，与脑血管疾病或神经退行性变的临床重叠可能具有重要意义。经颅超声检查发现的单相抑郁症特有的脑干结构变化可能有助于理解情感性精神病。磁共振波谱和功能MRI未来可能会推动精神疾病研究。
