Neuroimaging as a diagnostic tool in dementia with Lewy bodies
Neuroimaging as a diagnostic tool in dementia with Lewy bodies
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DOI：
10.1159/000074679
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发表时间：
2004-01-01
影响因子：
2.4
通讯作者：
Small, GW
中科院分区：
文献类型：
--
作者：
Small, GW
由于相似的表现症状，许多医生发现很难区分路易体痴呆症（DLB）与阿尔茨海默病或帕金森病痴呆症。DLB的病理诊断已经改善，因为发现了α-突触核蛋白，一种在路易体中发现的蛋白质探针。然而，病理诊断只能在死后进行，因此仍然需要可以用于指导患者管理的诊断技术。已经开发了用于建立DLB的临床诊断的共识标准，但它们缺乏敏感性。因此，最近的文献进行了审查，以确定是否神经影像学研究是有用的诊断工具，以帮助区分这些综合征。至少有六种类型的测试可以用来对痴呆症患者的大脑进行成像。结构研究（X射线、磁共振成像和计算机断层扫描）可以揭示中风后遗症和其他病变的存在，而功能研究（磁共振光谱、正电子发射断层扫描和单光子发射计算机断层扫描）可以揭示代谢和血流改变，这可能是不同类型痴呆的特征。虽然需要更正式的研究来证实这些成像技术是DLB的可靠诊断工具，并允许建立其使用指南，但神经成像技术目前正在实践中用于区分痴呆类型作为治疗指南。版权所有（C）2004 S. Karger AG，巴塞尔。
Due to similar presenting symptoms, many physicians find it difficult to distinguish cases of dementia with Lewy bodies (DLB) from Alzheimer's disease or Parkinson's disease with dementia. The pathologic diagnosis of DLB has improved because of the discovery of probes for alpha-synuclein, a protein found in Lewy bodies. However, pathologic diagnosis can be employed postmortem only, and therefore diagnostic techniques that can be employed to guide patient management are still needed. Consensus criteria have been developed for establishing a clinical diagnosis of DLB, but they lack sensitivity. Therefore, a review of the recent literature was conducted to establish whether neuroimaging studies are useful diagnostic tools to help differentiate these syndromes. At least six types of tests can be used to image the brain of patients with dementia. Structural studies (x-ray, magnetic resonance imaging and computerized tomography) can disclose the presence of stroke sequelae and other lesions, whereas functional studies (magnetic resonance spectroscopy, positron emission tomography and single-photon emission computed tomography) can disclose metabolic and blood flow alterations that may be characteristic for different types of dementia. Although more formal studies are needed to confirm that these imaging techniques are reliable diagnostic tools for DLB and permit the establishment of guidelines for their use, neuroimaging techniques currently are being employed in practice to differentiate dementia types as a guide to treatment. Copyright (C) 2004 S. Karger AG, Basel.