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

阿尔茨海默病患者的脑灌注SPECT显示颞顶区低灌注区。ROI法的直观半定量分析具有主观性。另一方面，统计参数图(SPM‘96)是检测多种情况下异常灌注区的一种有用的客观工具。本研究旨在评价脑灌注SPECT和SPM在阿尔茨海默病个体化诊断中的作用。我们还对一种新的统计方法3D-SSP(立体定向表面投影)进行了评估。研究结果显示了以下四点：1.结论：1.SPM和3D-SSP可以发现阿尔茨海默病患者双侧颞叶和顶叶典型的低灌注区，甚至在早期痴呆患者中也能检出扣带回后部。SPM有一个问题，根据大脑萎缩，这是大脑内侧的伪影，但3D-SSP显示没有这样的伪影。3D-SSP优于SPM。SPM或3D-SSP脑灌注SPECT对早期阿尔茨海默病的个体化诊断有一定价值。3D-SSP被推荐给有脑萎缩的高龄患者。结论脑SPECT SPECT结合SPM或3D-SSP是诊断早期阿尔茨海默病的有效方法。

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.