Ishiwata A, Kitamura S, Nagazumi A, Terashi A
Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Nihon Ika Daigaku Zasshi. 1998 Apr;65(2):140-7. doi: 10.1272/jnms1923.65.140.
In order to further understand the pathology of Alzheimer's disease (AD), we have utilized image analysis in diagnosing the early stages of AD in patients with cognitive disorders. CT and MRI, however, have not been feasible since only atrophy is seen and it is difficult to differentiate the changes in AD from age associated changes. In this study we tried to determine whether regional cerebral blood flow (rCBF) measurements using single photon emission CT (SPECT) are feasible for the early diagnosis of AD. Regional CBF (rCBF) was measured using SPECT in three subject groups: Age-associated memory impairment (AAMI. n = 9), mild AD (n = 16), and normal aged patients (mean age = 68.3; n = 20). The subjects were then observed for three years. The region of interest (ROI) for the medial temporal lobe was set at OM-30 degrees to cover the maximum area of the hippocampus. The absolute values of rCBF in the frontal, temporal, and parietal lobes and the cerebellum were significantly lower in the mild AD subjects than in the normal aged subjects. A significant decrease in rCBF was also seen in the medial temporal lobe in both the AD and the AAMI subjects compared to the normal controls. During the three years of follow up, no cases of dementia were seen in the AAMI subjects. However, there were two patients who appeared to have difficulty in adapting to daily life due to amnesia, one with a decrease in rCBF of the medial temporal lobe on the second SPECT, and the other showing a low rCBF the first time. This study suggests that AAMI subjects may comprise both AD and normal subjects. Therefore a more prospective study is needed.
为了进一步了解阿尔茨海默病（AD）的病理学，我们利用图像分析来诊断认知障碍患者的AD早期阶段。然而，CT和MRI并不可行，因为只能看到萎缩，且难以将AD的变化与年龄相关的变化区分开来。在本研究中，我们试图确定使用单光子发射计算机断层扫描（SPECT）测量局部脑血流量（rCBF）是否可用于AD的早期诊断。使用SPECT对三组受试者进行了局部脑血流量（rCBF）测量：年龄相关性记忆障碍（AAMI，n = 9）、轻度AD（n = 16）和正常老年患者（平均年龄 = 68.3；n = 20）。然后对受试者进行了三年的观察。内侧颞叶的感兴趣区域（ROI）设定在OM - 30度，以覆盖海马体的最大面积。轻度AD受试者额叶、颞叶、顶叶和小脑的rCBF绝对值显著低于正常老年受试者。与正常对照组相比，AD和AAMI受试者的内侧颞叶rCBF也显著降低。在三年的随访期间，AAMI受试者中未出现痴呆病例。然而，有两名患者因失忆似乎难以适应日常生活，一名患者在第二次SPECT检查时内侧颞叶rCBF降低，另一名患者首次检查时rCBF就较低。本研究表明，AAMI受试者可能包括AD患者和正常受试者。因此，需要进行更具前瞻性的研究。
