DOES COMPUTED TOMOGRAPHIC BRAIN IMAGING HAVE A PLACE IN THE DIAGNOSIS OF DEMENTIA
DOES COMPUTED TOMOGRAPHIC BRAIN IMAGING HAVE A PLACE IN THE DIAGNOSIS OF DEMENTIA
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DOI：
10.1001/archinte.152.7.1437
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发表时间：
1992-07-01
影响因子：
--
通讯作者：
GELBER, J
中科院分区：
文献类型：
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作者：
ENGEL, PA;GELBER, J
背景资料。-头部的计算机断层扫描(CT)是评估痴呆症的公认常规。这项研究试图确定一组患者，其中脑成像为临床图像添加了有意义的数据。-100名符合《精神疾病诊断和统计手册》第三版修订版中定义的痴呆症标准的患者接受了计算机断层成像。仅从临床数据来看，其中56例患者还符合以下诊断可能阿尔茨海默病(PAD)的严格标准：Mckhann PAD标准，《精神疾病诊断和统计手册》修订版第三版，原发性退行性痴呆标准，改良Hachinski缺血量表评分<4分，神经学检查正常，症状至少1年。-在PAD组中，8例(14%)有萎缩以外的异常；只有3例(2例显示腔隙，1例显示梗塞)可能具有临床意义。在44例不符合PAD标准的患者中，23例(52%)扫描异常，其中15例为脑梗塞，2例为脑室周围透明，3例为肿瘤，1例为脑积水。-这些结果支持了计算机断层扫描对非典型痴呆的诊断价值，以及其在PAD中的有限应用。这些数据表明，CT在痴呆诊断中的应用可以制定临床指南。
Background. - Computed tomographic (CT) scanning of the head is an accepted routine in the evaluation of dementia. This study attempted to identify a patient group in which brain imaging adds meaningful data to the clinical picture.Methods. - One hundred patients who met criteria for dementia as defined in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, underwent computed tomographic imaging. From clinical data alone, 56 of these patients also met the following strict criteria for the diagnosis of probable Alzheimer's disease (PAD): the McKhann criteria for PAD, Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria for primary degenerative dementia, a score of less than 4 on the modified Hachinski Ischemia Scale, a normal neurologic examination and symptoms for at least 1 year.Results. - In the PAD group, eight scans (14%) had abnormalities other than atrophy; only three (two showing lacunae and one showing infarct) were of possible clinical significance. In the 44 patients not meeting PAD criteria, 23 scans (52%) were abnormal, including 15 with infarcts, two with periventricular lucencies, three showing tumors, and one showing hydrocephalus.Conclusions. - These results support the diagnostic value computed tomographic scanning in atypical dementia and its limited utility in PAD. The data indicate that clinical guidelines can be developed for the application of CT in the diagnosis of dementia.