Bartenstein P, Minoshima S, Hirsch C, Buch K, Willoch F, Mösch D, Schad D, Schwaiger M, Kurz A
Department of Nuclear Medicine, Technical University Munich, Germany.
J Nucl Med. 1997 Jul;38(7):1095-101.
This study evaluated an automated analysis of SPECT brain imaging in patients with Alzheimer's disease (AD).
Patients [n = 81; mean age, 69.9 +/- 10.6 yr (mean +/- s.d.)] with a clinical diagnosis of probable AD (NINCDS-Alzheimer's Disease and Related Disorders Association criteria) underwent 99mTc-ethyl cysteine dimer SPECT imaging. After imaging registration and data extraction using three-dimensional stereotactic surface projections, a pixel-wise comparison of ethyl cysteine dimer uptake was performed using a reference database of 10 cognitive intact controls of comparable age.
When individual cases were compared to the normal database, temporo-parietal regional cerebral blood flow (rCBF) abnormalities across different levels of dementia severity were clearly depicted on pixel-wise Z-score images. The rCBF reduction in cortical association areas showed a significant correlation with an overall level of cognitive decline, as assessed by the Mini Mental State Examination and by the cognitive section of the Cambridge Mental Disorders of the Elderly Examination. In addition, there were significant region-specific correlations between left temporo perfusion deficit and language performance and between right parietal rCBF reduction and praxis.
These results indicate that this observer-independent analysis of SPECT data enables objective and semiquantitative assessment of the magnitude and extent of cortical perfusion abnormalities in patients with AD.
本研究评估了阿尔茨海默病（AD）患者SPECT脑成像的自动分析。
临床诊断为可能的AD（根据美国国立神经疾病和中风研究所 - 阿尔茨海默病及相关疾病协会标准）的患者[n = 81；平均年龄，69.9 +/- 10.6岁（平均值 +/- 标准差）]接受了99mTc - 乙基半胱氨酸二聚体SPECT成像。在使用三维立体定向表面投影进行成像配准和数据提取后，使用10名年龄相当的认知正常对照的参考数据库对乙基半胱氨酸二聚体摄取进行逐像素比较。
当将个体病例与正常数据库进行比较时，在逐像素Z分数图像上清晰地描绘了不同痴呆严重程度水平下颞顶叶区域脑血流（rCBF）异常。通过简易精神状态检查和剑桥老年精神障碍认知部分评估，皮质联合区域的rCBF降低与认知衰退的总体水平显著相关。此外，左侧颞叶灌注不足与语言表现之间以及右侧顶叶rCBF降低与实践能力之间存在显著的区域特异性相关性。
这些结果表明，这种对SPECT数据的独立于观察者的分析能够客观和半定量地评估AD患者皮质灌注异常的程度和范围。
