多梗塞性痴呆和Alzheimer型痴呆的SPECT和MRI比较研究

Comparative study of SPECT and MRI in dementia of multi infarct and Alzheimer type.

对２２例多梗塞性痴呆（ＭＩＤ）、１５例Ａｌｚｈｅｉｍｅｒ型痴呆（ＤＡＴ）病人和２４例同龄、同利手健康对照组作了单光子发射计算机断层显象（ＳＰＥＣＴ）和磁共振成象（ＭＲＩ）检查（对照组仅１２例作ＭＲＩ）。结果发现ＳＰＥＣＴ在ＭＩＤ病人主要表现为多发性、局灶性脑放射性减低，两侧不对称，以额皮质、皮质下明显；ＤＡＴ病人主要表现为大脑皮质放射性对称性降低，以颞顶枕明显。ＭＲＩ在ＭＩＤ病人主要表现为顶皮质萎缩、大脑不同部位梗塞灶；ＤＡＴ病人主要表现为大脑皮质萎缩，颞顶枕为甚，半数以上病例海马萎缩。结果提示两种检查对诊断和鉴别ＭＩＤ、ＤＡＴ有一定价值。

Twenty two patients with multi infarct dementia(MID),fifteen patients with dementia of Alzheimer type(DAT) and twenty four controls matched for age and handedness were investigated by single photon emission computed tomography(SPECT) with 99m Tc ECD.In all persons of MID group,multiple focal perfusion deficits to cortical and subcortical areas were found asymmetrically,mostly to frontal cortex and subcortical regions.Perfusion deficits in bilateral cerebral were found in all patients with DAT,especially in temporal,parietal and occipital cortex.Magnetic resonance imaging(MRI) brain scan was performed in all patients and 12 controls at the same time,and demonstrated atrophy of parietal cortex in all pateints and cerebral infarcts of variant areas in most of MID.Atrophy of cerebral cortex,especially in temporal,parietal and occipital cortex were presented in all patients of DAT.Atrophy of hippocampus were revealed in more than half of patients with DAT.The results suggested that SPECT or MRI was important for diagnosis and differential diagnosis of MID and DAT patients.The value of each of both methods is limited,but combination of them is more helpful in differential diagnosis of MID and DAT.