Basic methods of evaluating brain images in the clinical diagnosis of dementia

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  • 認知症診療に必要な脳画像の見かた
  • ―初級編―

Abstract

<p>In this article, I discuss the key radiological features and recommended diagnostic approaches of routine structural and functional neuroimaging to assess neurodegenerative disease. This review covers the more common dementias, including Alzheimer disease, frontotemporal lobar degeneration, supranuclear palsy, and normal pressure hydrocephalus. I describe the circumscribed patterns of atrophy across these dementias, highlighting the prototypical volumetric changes seen in cortical and subcortical regions of interest as a function of disease progression. I draw particular attention to the patterns of corticolimbic atrophy in Alzheimer disease and frontotemporal lobar degeneration as well as the stereotypic "hummingbird" appearance of brainstem degeneration in progressive supranuclear palsy. I additionally consider the relevance of normal pressure hydrocephalus among the dementia etiologies, with its associated pattern of ventriculomegaly and disproportionately-enlarged subarachnoid space. As both early diagnosis and accurate differential diagnosis are important to achieve timely and meaningful treatment planning, knowledge of these neuroradiological features is vital. Furthermore, the ability to situate neuroimaging outcomes with clinical findings.</p>

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