Neuroscintigraphy of Non-Alzheimer’s Disease Dementias
K Wang, YL Dai, TCY Cheung, DLK Dai
Hong Kong J Radiol 2015;18:74-86
DOI: 10.12809/hkjr1414268
Neuroscintigraphy for dementia includes brain perfusion single-photon emission computed tomography (SPECT) [hexamethylpropyleneamine oxime or ethyl cysteinate dimer] and fluorodeoxyglucose positron emission tomography (PET), which are the two most common functional imaging procedures for the brain. The two procedures detect the physiological blood flow and metabolic glucose uptake in the brain, respectively. These functional scans are invaluable in early diagnosis, as well as for confirmation in difficult clinical cases of dementia. Various types of dementia show specific scintigraphic patterns and, together with clinical correlation and anatomical imaging correlation, accurate clinicoradiological diagnosis can often be achieved. Advanced software such as Talairach analysis further improves the sensitivity of brain SPECT by showing a 3-dimensional surface display of the perfusion pattern. Additional brain scintigraphy — including cerebral amyloid PET, cerebral dopaminergic PET, and indium-111 cisternogram — are sometimes indicated for special reasons such as atypical clinical presentation or equivocal imaging findings. Finally, frequent clinicoradiological conference helps mutual improvement in clinical utilisation as well as the specificity of neuroimaging.
中文摘要
非阿爾茨海默型癡呆症的腦神經顯像
王琪、戴毓玲、張智欣、戴樂群
老年癡呆症的神經閃爍掃描技術包括腦灌注單光子發射電腦斷層顯像（SPECT）〔hexamethylpropyleneamineoxime或ethyl cysteinate dimer〕和氟正電子發射斷層掃描（PET），這是兩種最常見的腦部功能成像方法。腦SPECT顯像分析血流灌注的生理狀況，PET則檢查腦部攝取葡萄糖代謝狀況。這些腦功能成像檢查對於早期診斷相當重要，而且對於臨床上難以與其他疾病鑒別的癡呆症病例更加有用。不同類型的癡呆症有其獨特的影像學表現，通過結合臨床表現及解剖結構的特點，便能做出明確診斷。先進軟件的分析（如Talairach analysis）能顯示腦灌注成像的三維模型，進一步提高腦SPECT的靈敏度。有時基於特別的原因（如出現非典型臨床表現或一些模棱兩可的影像表現）須進行額外的大腦顯像分析，如腦內澱粉樣蛋白PET、腦多巴胺PET和銦111腦池顯像。經常舉行臨床影像研討會有助提高對腦神經影像學檢查在臨床中的應用，並且能發揮其特有的檢查優勢。