RSS-Feed abonnieren
DOI: 10.1055/s-2004-820585
Stellenwert der strukturellen und funktionellen Bildgebung bei Demenzen
The Value of Structural and Functional Imaging in DementiaPublikationsverlauf
Publikationsdatum:
04. März 2004 (online)
![](https://www.thieme-connect.de/media/rad-u2d/200401/lookinside/thumbnails/10.1055-s-2004-820585-1.jpg)
Zusammenfassung
Die bildgebende strukturelle und funktionelle Diagnostik liefert einen eigenen Beitrag zur klinischen Diagnostik und Differenzialdiagnostik der Demenzen. Die Analyse der strukturellen Veränderungen, Hirnatrophie bzw. Läsionen des Hirnparenchyms ist mit sensitiven (Magnetresonanz-)Untersuchungstechniken vergleichsweise einfach, die Ergebnisse besitzen bei isolierter Betrachtung aber nur eine geringe Spezifität. Zunehmend bekommen neben der Magnetresonanzspektroskopie funktionelle, aus der strukturellen Bildgebung abgeleitete Untersuchungsmethoden wie Magnetization Transfer Ratio (MTR) oder Diffusion Tensor Imaging (DTI) bzw. die funktionelle MRT eine Bedeutung. Gesicherte Ergebnisse der strukturellen und funktionellen Bildgebung werden für diagnostisch und differenzialtherapeutisch bedeutsame Demenzerkrankungen dargestellt und orientierend mit den Ergebnissen der Nuklearmedizin verglichen.
Abstract
Structural and functional diagnostic imaging provides a distinctive contribution to the clinical and differential diagnosis in dementia. Sensitive magnetic resonance techniques make the analysis of structural changes, brain atrophy and lesions of the cerebral parenchyma relatively simple, but a particular finding only has a low specificity. Magnetic resonance spectroscopy and innovative structural techniques, such as magnetization transfer ratio (MTR), diffusion tensor imaging (DTI) and functional magnetic resonance tomography, become increasingly important. Results of structural and functional diagnostic imaging are documented in reference to their diagnostic and differential therapeutic contribution to relevant dementias and are cautiously compared with the results of nuclear medicine.
Key words
Dementias, - Diagnostics, - Imaging, - Radiology, - Nuclear Medicine
Literatur
- 1 Aicher F, Wagner M, Kremser C, Felber S. MR-imaging of non-Alzheimer dementia. J Neural Transm. 1996; 47 (Suppl) 143-153
- 2 Bateman G A. The reversibility of reduced cortical vein compliance in normal-pressure hydrocephalus following shunt insertion. Neuroradiology. 2003; 45 65-70
- 3 Bergui M, Bradac G B, Rossi G, Orsi L. Extensive cortical damage in a case of Creutzfeldt-Jacob disease: clinicoradiological correlations. Neuroradiol. 2003; 45 304-307
- 4 Charness M E. Intracranial voyeurism: revealing the mammillary bodies in alcoholism. Alcohol Clin Exp Res. 1999; 23 1941-1944
- 5 Chetelat G, Baron J C. Ealy diagnosis of Alzheimer’s disease: contribution of structural neuroimaging. Neuroimage. 2003; 18 525-541
- 6 Coffman J A, Torello M W, Bornstein R A. et al . Leukoaraiosis in asymptomatic adult offspring in individuals with Alzheimer’s disease. Biol Psychiat. 1990; 27 1244-1248
- 7 Couldhard A, Blank S C, Bushby K. et al . Distribution of cranial MRI abnormalities in patients with symptomatic and subclinic CADASIL. Br J Radiology. 2000; 73 256-265
- 8 Demaerel P, Sciot R, Robbrecht W. et al . Accuracy of diffusion-weighted MR imaging in the diagnosis of sporadic Creutzfeldt-Jakob disease. J Neurol. 2003; 250 222-225
- 9 DelaTorre J C. Alzheimer disease as a vascular disorder. Stroke. 2002; 33 1152-1162
- 10 DeSanti S, deLeon M J, Rusinek H. et al . Hippocampal function glucose metabolism and volume loss in MCI and AD. Neurobiol Aging. 2001; 22 529-539
- 11 Devous M D. Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies. Eur J Nucl Med. 2002; 29 1685-1696
- 12 Doi T, Iwasa K, Makifuch T, Takimori M. White matter hyperintensities on MRI in a patient with corticobasal degeneration. Acta Neurol Scand. 1999; 99 199-201
- 13 Eschweiler G W, Wormstall H, Bartels M. Was unterscheidet die Subtypen der Creutzfeldt-Jakob-Krankheit von anderen Demenzen mit initialen psychiatrischen Auffälligkeiten? . Nervenheilkunde. 2003; 22 24-29
- 14 Fazekas F. Magnetic resonance signal abnormalities in asymptomatic individuals: their incidence and functional correlates. Eur Neurol. 1998; 29 164-168
- 15 Golomb J, Kluger A, deLeon M J. et al . Hippocampal formation size predicts declinining memory performance in normal aging. Neurology. 1996; 47 810-813
- 16 Hanyu H, Asano T, Sakurai H. et al . Diffusion-weighted and magnetization transfer imaging of the corpus callosum in Alzheimer’s disease. J Neurol Sci. 1999; 167 37-44
- 17 Hentschel F, Braus D F, Zerfaß R, Förstl H. Die kortikobasale Degeneration (KBD) in Computertomographie und Magnetresonanztomographie. Fortschr Röntgenstr. 1995; 163 88-90
- 18 Hentschel F, Zerfaß R, Becker G. et al . Neuroradiologische Befunde bei Alzheimer-Demenz mit Presenilin Mutation. Fortschr Röntgenstr. 1998; 168 97-100
-
19 Hentschel F.
Radiologische Bildgebung in der Psychiatrie. In: Stoppe G, Hentschel F, Munz DL (Hrsg.). Bildgebende Verfahren in der Psychiatrie. Stuttgart; Thieme 2000: 2-37 - 20 Hentschel F, Kreis M, Damian M, Krumm B. Mikroangiopathische Läsionen in der weißen Hirnsubstanz: Quantifizierung und Korrelation mit psychologischen Testergebnissen. Nervenarzt. 2003; 74 55-61
- 21 Hentschel F, Kreis M, Damian M, Syren M, Krumm B. Evaluation des Beitrages der radiologischen bildgebenden Diagnostik bei demenziellen Erkrankungen - ein Vergleich mit der psychologischen Diagnostik. Fortschr Röntgenstr. 2003; 175 1335-1343
- 22 Hentschel F, Damian M, Kreis M, Krumm B. Auswirkungen der erweiterten klinischen Diagnostik auf das Diagnosespektrum einer Gedächtnisambulanz. Gerontologie und Geriatrie (im Druck)
- 23 Hentschel F, Kreis M, Damian M, Krumm B. Der Beitrag der Magnetization transfer Ratio (MTR) zur Diagnostik und Differentialdiagnostik der Demenzen. Nervenarzt (eingereicht)
- 24 Herholz K. Diagnostic imaging of dementia in the elderly. Arch Gerontol Geriatr. 1997; 25 5-12
- 25 Herholz K, Schopphoff H, Schmidt M. et al . Direct comarison of spatially normalized PET and SPECT scans in Alzheimer’s disease. J Nukl Med. 2002; 43 21-26
- 26 Holodny A I, Waxman R, George A E. et al . MR differential diagnosis of normal-pressure hydrocephalus and Alzheimer disease: significance of perihippocampal fissures. AJNR Am J Neuroradiol. 1998; 19 813-819
- 27 Jacobs A H, Li H, Winkeler A. et al . PET- based molecular imaging in neuroscience. Eur J Nucl Med. 2003; 30 1051-1065
- 28 Kalaria R N. Small vessel disease and Alzheimer’s dementia: pathological considerations. Cerebrovascular Diseases. 2002; 13 (suppl 2) 48-52
- 29 Kitagaki H, Mori E, Ishii K. et al . CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry. AJNR Am J Neuroradiol. 1998; 19 1277-1284
-
30 Kohlmeyer K.
Neuroradiologie. In: Platt D (ed) Handbuch der Gerontologie. Stuttgart; Gustav Fischer Verlag 1989: 107-130 - 31 Kraft E, Schwarz J, Trenkwalder C. et al . The combination of hypointense and hyperintense signal changes on T2-weighted magnetic resonance imaging sequences. Arch Neurol. 1999; 56 225-228
- 32 Krausz Y, Bonne O, Gorfine M. et al . Age-related changes in brain perfusion of normal subjects detected by 99mTc-HMPAO SPECT. Neuroradiology. 1998; 40 428-434
- 33 Kuwert T, Bartenstein P, Grünwald F. et al . Klinische Wertigkeit der Positronen-Emissions-Tomographie in der Neuromedizin. Nervenarzt. 1998; 69 1045-160
- 34 Laakso M P, Soininen H, Partanen K. et al . MRI of the hippocampus in Alzheimer’s disease: sensitivity, specifity, and analysis of the incorrectly classified subjects. Neurobiol Aging. 1998; 19 23-31
- 35 Mueller E A, Moore M M, Kerr D CR. et al . Brain volume preserved in healthy elderly through the elevanth decade. J Neurol. 1998; 51 1555-1562
- 36 Parazzini C, Mammi S, Comola M, Scotti G. Magnetic resonance diffusion-weighted images in Creutzfeldt-Jakob disease: a case report. Neuroradiology. 2003; 45 50-52
- 37 Parnetti L, Tarducci R, Presciutti O. et al . Proton magnetic resonance spectroscopy can differentiate Alzheimer’s disease from normal aging. Mech Ageing Dev. 1997; 97 9-14
- 38 Pasquir J, Michel B F, Brenot-Rossi I. et al . Value of 99mECD SPET for the diagnosis of dementia with Lewy bodies. Eur J Nucl Med. 2002; 29 1342-1348
- 39 Petrella J R, Coleman R E, Doraiswami P M. Neuroimaging and early diagnosis of Alzheimer disease: a look to the future. Radiology. 2003; 226 315-336
- 40 Pickuth D, Heywang-Köbrunner S H, Spielmann R P. Was bringt das Routine-CCT bei psychiatrischen Patienten wirklich? VO-512, 80. Dt. Röntgenkongress, Wiesbaden 1999. Fortschr Röntgenstr. 1999; 170 (Suppl) 168
- 41 Roman G C, Tatemichi T K, Erkinjuntti T. et al . Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993; 43 250-260
- 42 Roob G, Schmidt R, Kapeller P. et al . MRI evidence of past cerebral microbleeds in a healthy elderly population. Neurology. 1999; 52 991-994
- 43 Rose S, Chen F, Chalk J B. et al . Loss of connectivity in Alzheimer’s disease: an evaluation of white matter tract integrity with color coded MR diffusion tensor imaging. J Neurol Neurosurg Psychiatry.. 2000; 69 528-530
- 44 Rosen A C, Bokde A LW, Pearl A, Yesavage J A. Ethical, and practical issues in applying functional imaging to the clinical management of Alzheimer’s disease. Brain and Cognition. 2002; 50 498-519
- 45 Sanchez-Pernaute R, Garcia-Segura J M, delBarrio A lba. et al . Clinical correlations of striatal HMRS changes in Huntington’s disease. J Neurol.. 1999; 53 806-812
- 46 Santens P, DeBleecker J, Goethals P. et al . Differential regional cerebral uptake of 18F-Fluoro-2-Deoxy-D-Glucose in Alzheimer’s disease and Frontotemporal dementia at initial diagnosis. Eur Neurol. 2000; 45 19-27
- 47 Scheltens P. Early diagnosis of dementia: neuroimaging. Journal of Neurology. 1999; 246 16-20
- 48 Schmidt R, Fazekas F, Kapeller P. et al . MRI white matter hyperintensities. Three-year follow-up of the Austrian Stroke Prevention Study. Neurology. 1999; 53 132-139
- 49 Sheedy D, Lara A, Garrick T, Harper C. Size of mamillary bodies in health and disease: useful measurements in neuroradiological diagnosis of Wernicke’s encephalopathy. Alcohol Clin Exp Res. 1999; 23 1624-1628
- 50 Shoghi-Jadid K, Small G W, Agdeppa E D. et al . Localization of neurofibrillary tangles and beta-amyloid plaques in the brains of living patients with Alzheimer disease. Am J Geriatr Psychiatry. 2002; 10 24-35
- 51 Silverberg G D, Levinthal E, Sullivan E V. et al . Assessment of low-flow CSF drainage as a treatment for AD. Results of a randomized pilot study. J Neurol. 2002; 59 1139-1145
- 52 Silverman D HS, Gambhir S S, Huang H WS. et al . Evaluating early dementia with and without assessment of regional cerebral metabolism by PET: a comparison of predicted costs and benefits. J Nucl Med. 2002; 43 253-266
- 53 Small S A, Bartsch D, Perera G M. et al . Imaging physiologic dysfunction of individual hipocampal subregions in humans and genetic modified mice. Neuron. 2000; 28 6536-6564
- 54 Smith A D, Jobst K A, Edmonds Z. et al . Neuroimaging and early Alzheimer’s disease. The Lancet. 1996; 348 830
- 55 Snowden J S. Sementic dysfunction in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord. 1999; 10 (suppl) 33-36
- 56 Sperling R A, Bates J F, Chua E J. et al . fMRI studies of associative encoding in young and elderly. J Neurol Neurosurg Psychiatry. 2003; 74 44-50
- 57 Tokumaru A M, O’uchi T, Kuru Y. et al . Corticobasal degeneration: MR with histopathologic comparison. AJNR Am J Neuroradiol. 1996; 17 1849-1852
- 58 Tschampa H J, Mürtz P, Flache S. et al . Thalamic involvement in sporadic Creutzfeldt-Jacob-disease: a diffusion-weighted MR imaging study. AJNR Am J Neuroradiol. 2003; 24 908-915
- 59 Varrone A, Pappata S, Caraco C. et al . Voxel-based comparison of rCBF SPET images in frontotemporal dementia and Alzheimer’s disease highlights the involvement of differential cortical networks. Eur J Nucl Med. 2002; 29 1447-1454
- 60 Wüllner U, Klockgether T. Klinik und Therapie der Multisystematrophie. Deutsches Ärzteblatt. 2003; 7 A408-A415
- 61 Yekhlef F, Ballan G, Marcia F. et al . Routine MRI for differential diagnosis of Parkinson’s disease, MSA, PSP, and CBD. J Neural Transm. 2003; 110 151-169
- 62 Zekry D, Duyckaerts C. et al . Degenerative and vascular lesions of the brain have synergistic effects in dementia of the elderly. Acta Neuropathol. 2002; 103 481-487
Korrespondenzadresse
Prof. Dr. Frank Hentschel
Abteilung Neuroradiologie ZI Fakultät für klinische Medizin Mannheim der Universität Heidelberg
68159 Mannheim J5
Telefon: +49 621 1703-864
Fax: +49 621 1703-137
eMail: hentsche@zi-mannheim.de