Hirsch C, Bartenstein P, Minoshima S, Mösch D, Willoch F, Buch K, Schad D, Schwaiger M, Kurz A
Department of Nuclear Medicine, Technical University, Munich, Germany.
Dement Geriatr Cogn Disord. 1997 Mar-Apr;8(2):98-104. doi: 10.1159/000106613.
The aim of the study was to evaluate an observer-independent semiquantitative analysis of brain imaging by single-photon emission computed tomography (SPECT) in patients with Alzheimer's disease (AD). Patients (n = 45, mean age 70 +/- 11 years) with a clinical diagnosis of AD according to NINCDS/ADRDA criteria were examined by 99mTc-ethylcysteine dimer SPECT. Following anatomic normalization and data extraction using three-dimensional stereotactic surface projection, a pixelwise comparison of ECD uptake was performed with the reference values of 10 cognitive intact controls of comparable age. The global relative decrease of cerebral blood flow in cortical association areas showed a significant inverse association with the overall level of cognitive functioning as assessed with the Mini Mental State Examination and with the cognitive section (CAMCOG) of the Cambridge Mental Disorders of the Elderly Examination. There were significant region-specific associations between left temporoparietal perfusion deficit and language performance and between right temporoparietal regional cerebral blood flow reduction and praxis. The results suggest that this observer-independent analysis of SPECT data provides a valid assessment of the pattern and severity of cortical perfusion abnormalities in patients with AD.
该研究的目的是评估采用单光子发射计算机断层扫描（SPECT）对阿尔茨海默病（AD）患者进行的与观察者无关的脑成像半定量分析。根据NINCDS/ADRDA标准临床诊断为AD的患者（n = 45，平均年龄70±11岁）接受了99mTc-乙基半胱氨酸二聚体SPECT检查。在使用三维立体定向表面投影进行解剖学标准化和数据提取后，将ECD摄取情况与10名年龄相当的认知功能正常对照者的参考值进行了逐像素比较。皮质联合区脑血流量的整体相对减少与通过简易精神状态检查评估的认知功能总体水平以及与剑桥老年精神障碍检查的认知部分（CAMCOG）呈显著负相关。左颞顶叶灌注不足与语言表现之间以及右颞顶叶局部脑血流减少与运用能力之间存在显著的区域特异性关联。结果表明，这种对SPECT数据的与观察者无关的分析为AD患者皮质灌注异常的模式和严重程度提供了有效的评估。
