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Usefulness of Follow‐up Regional Cerebral Blood Flow Measurements by Single‐Photon Emission Computed Tomography in the Differential Diagnosis of Dementia
Author(s) -
Golan Haim,
Kremer Janus,
Freedman Morris,
lchise Masanori
Publication year - 1996
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon19966123
Subject(s) - dementia , medicine , cerebral blood flow , single photon emission computed tomography , differential diagnosis , dementia with lewy bodies , frontotemporal dementia , progressive supranuclear palsy , depression (economics) , psychiatry , nuclear medicine , radiology , cardiology , disease , pathology , economics , macroeconomics
The aim of this study was to evaluate whether follow‐up measurements of regional cerebral blood flow (rCBF) by single‐photon emission computed tomography (SPECT) provide additional information in the differential diagnosis of dementia. Thirty‐six patients (70 ± 14 yr) with suspected dementia who had two technetium 99m‐hexamethylpropyleneamineoxime SPECT scans over 18 ± 7 months were included in this retrospective study. The patients comprised three groups based on the final clinical diagnosis: (1) neurodegenerative disorder (NDD) including Alzheimer's disease (AD) (n = 13), frontotemporal lobe dementia (n = 2), progressive supranuclear palsy (n = 1 ), and mixed dementia (AD plus multi infarct dementia [MID]) (n = 3); (2) MID (n = 8); and (3) psychiatric disorders (depression [n = 7]. psychosis [n = 1]. and anxiety [n = 1 ]). Blinded to the clinical diagnosis and using visual analysis, the nuclear medicine physicians compared the second scan with the first scan for each patient to characterize temporal changes in rCBF. SPECT findings were categorized into three patterns of rCBF change: worsened, improved, and unchanged. Of the worsened rCBF group, 17 (85%) belonged to the NDD group whereas 2 (1 0%) and 1 (5%) belonged to the MID and psychiatric disorders groups, respectively. All 5 (1 00%) of the improved rCBF patients belonged to the psychiatric disorders group. Thus, worsening of rCBF favors the diagnosis of NDD whereas improvement in rCBF may mitigate against the diagnosis of NDD or MID. Follow‐up rCBF measurements by SPECT thus provided additional information on the possible cause of dementia. A prospective study to further evaluate the usefulness of follow‐up rCBF measurements by SPECT appears warranted.