Multimodality Imaging of Dementia: Clinical Importance and Role of Integrated Anatomic and Molecular Imaging
Multimodality Imaging of Dementia: Clinical Importance and Role of Integrated Anatomic and Molecular Imaging
复制标题
DOI：
10.1148/rg.2020190070
复制
发表时间：
2020-01-01
期刊：
影响因子：
5.5
通讯作者：
Rajadhyaksha，Chetan D.
中科院分区：
文献类型：
--
作者：
Patel，Kunal P.;Wymer，David T.;Rajadhyaksha，Chetan D.
神经退行性疾病是一组破坏性的疾病，很难准确诊断。尽管由于治疗选择相对有限，这些疾病很难管理，但早期和正确的诊断有助于管理症状和应对这些疾病过程的后期阶段。解剖结构成像和生理分子成像都已经发展到可以相对较早地、高精度地识别这些神经退变过程的状态。为了确定潜在的疾病，放射科医生应该了解不同的分布和涉及的病理生理过程。高空间分辨率的MRI可以检测细微的形态变化，以及潜在的并发症和替代诊断，而分子成像可以可视化功能改变或疾病特异性标志物异常增加或减少的情况。这些方法是相辅相成的。诊断性研究的适当检查和解释需要综合的、多模式的、多学科的方法。本文综述了核磁共振成像和核医学成像的方法和结果，包括氟脱氧葡萄糖、淀粉样蛋白示踪剂和多巴胺能转运体成像(碘氟烷)的使用。还回顾了一些主要神经退变过程的病理生理学及其临床表现；这些信息对于了解这些成像方式是如何工作的至关重要，它有助于整合临床数据以帮助合成最终诊断。放射科医生和核医学医生的目标是将神经退行性疾病的评估纳入他们的实践中，他们应该了解并熟悉可用的多种成像模式，以及使用这些模式在神经退行性疾病患者的多学科管理中是如何必不可少的。
Neurodegenerative diseases are a devastating group of disorders that can be difficult to accurately diagnose. Although these disorders are difficult to manage owing to relatively limited treatment options, an early and correct diagnosis can help with managing symptoms and coping with the later stages of these disease processes. Both anatomic structural imaging and physiologic molecular imaging have evolved to a state in which these neurodegenerative processes can be identified relatively early with high accuracy. To determine the underlying disease, the radiologist should understand the different distributions and pathophysiologic processes involved. High-spatial-resolution MRI allows detection of subtle morphologic changes, as well as potential complications and alternate diagnoses, while molecular imaging allows visualization of altered function or abnormal increased or decreased concentration of disease-specific markers. These methodologies are complementary. Appropriate workup and interpretation of diagnostic studies require an integrated, multimodality, multidisciplinary approach. This article reviews the protocols and findings at MRI and nuclear medicine imaging, including with the use of flurodeoxyglucose, amyloid tracers, and dopaminergic transporter imaging (ioflupane). The pathophysiology of some of the major neurodegenerative processes and their clinical presentations are also reviewed; this information is critical to understand how these imaging modalities work, and it aids in the integration of clinical data to help synthesize a final diagnosis. Radiologists and nuclear medicine physicians aiming to include the evaluation of neurodegenerative diseases in their practice should be aware of and familiar with the multiple imaging modalities available and how using these modalities is essential in the multidisciplinary management of patients with neurodegenerative diseases.©RSNA, 2020