DIAGNOSIS OF ALZHEIMER'S DISEASE USING HM-PAO SPECT WITH STATISTICAL ANALYSIS (SPM OR 3D-SSP)

阿尔茨海默病脑灌注SPECT显示颞顶叶灌注不足。用ROI方法进行可视化和半定量分析是主观的。另一方面，统计参数映射（SPM'96）是一种有用的客观工具，可以在几种情况下检测异常灌注区域。本研究的目的是评价脑灌注SPECT和SPM在阿尔茨海默病个体诊断中的能力。我们还评估了一种新的统计方法，3D-SSP（立体定向表面投影）。结果显示了以下四点。SPM和3D-SSP可以检测到阿尔茨海默病患者双侧颞叶和顶叶的典型灌注不足区域，即使在早期痴呆患者也可以检测到扣带回后区。根据脑萎缩，SPM有一个问题，即大脑内侧有伪影，但3D-SSP没有显示这样的伪影。3D-SSP优于SPM.3。脑灌注SPECT与SPM或3D-SSP在早期阿尔茨海默病的个体诊断中有用。3D-SSP推荐用于可能发生脑萎缩的老年患者。应收集更多的正常对照病例，建立性别和年龄匹配对照数据库，用于自动诊断。我们认为脑灌注SPECT与SPM或3D-SSP可能是诊断早期阿尔茨海默病的有用工具。

Cerebral perfusion SPECT in Alzheimer's disease shows hypoperfusion in the temporo-parietal region. Visual and semi-quantitative analysis with ROI method is subjective. On the other hand, Statistical Parametric Mapping (SPM'96) is a useful objective tool to detect abnormal perfusion area in several conditions. The aim of this study was to evaluate the capability of cerebral perfusion SPECT and SPM in individual diagnosis of Alzheimer's disease. We also evaluated a new statistical method, 3D-SSP (stereotactic surface projection). The results showed the following four points.1. SPM and 3D-SSP could detect typical hypoperfusion areas in the bilateral temporal lobe and parietal lobe in Alzheimer's disease, and the posterior cingulate gyrus even in early dementia.2. SPM had a problem that were artifacts in the medial aspect of the cerebrum according to cerebral atrophy, but 3D-SSP showed no such artifacts. 3D-SSP was better than SPM.3. Cerebral perfusion SPECT with SPM or 3D-SSP was useful in individual diagnosis of early Alzheimer disease. 3D-SSP was recommended in elder patients who would have brain atrophy.4. We should collect much more normal control case, and make sexual and aged matching control database for automatic diagnosis.We concluded that cerebral perfusion SPECT with SPM or 3D-SSP could be a useful tool to diagnose early Alzheimer disease.