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Brain perfusion SPECT in dementia: what radiologists should know.
Imokawa, Tomoki; Yokoyama, Kota; Takahashi, Kanae; Oyama, Jun; Tsuchiya, Junichi; Sanjo, Nobuo; Tateishi, Ukihide.
Afiliación
  • Imokawa T; Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
  • Yokoyama K; Department of Radiology, Japanese Red Cross Omori Hospital, Ota-Ku, Tokyo, Japan.
  • Takahashi K; Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan. kota1986ky@yahoo.co.jp.
  • Oyama J; Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
  • Tsuchiya J; Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
  • Sanjo N; Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
  • Tateishi U; Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
Jpn J Radiol ; 2024 Jun 18.
Article en En | MEDLINE | ID: mdl-38888851
ABSTRACT
The findings of brain perfusion single-photon emission computed tomography (SPECT), which detects abnormalities often before changes manifest in morphological imaging, mainly reflect neurodegeneration and contribute to dementia evaluation. A major shift is about to occur in dementia practice to the approach of diagnosing based on biomarkers and treating with disease-modifying drugs. Accordingly, brain perfusion SPECT will be required to serve as a biomarker of neurodegeneration. Hypoperfusion in Alzheimer's disease (AD) is typically seen in the posterior cingulate cortex and precuneus early in the disease, followed by the temporoparietal cortices. On the other hand, atypical presentations of AD such as the posterior variant, logopenic variant, frontal variant, and corticobasal syndrome exhibit hypoperfusion in areas related to symptoms. Additionally, hypoperfusion especially in the precuneus and parietal association cortex can serve as a predictor of progression from mild cognitive impairment to AD. In dementia with Lewy bodies (DLB), the differentiating feature is the presence of hypoperfusion in the occipital lobes in addition to that observed in AD. Hypoperfusion of the occipital lobe is not a remarkable finding, as it is assumed to reflect functional loss due to impairment of the cholinergic and dopaminergic systems rather than degeneration per se. Moreover, the cingulate island sign reflects the degree of AD pathology comorbid in DLB. Frontotemporal dementia is characterized by regional hypoperfusion according to the three clinical types, and the background pathology is diverse. Idiopathic normal pressure hydrocephalus shows apparent hypoperfusion around the Sylvian fissure and corpus callosum and apparent hyperperfusion in high-convexity areas. The cortex or striatum with diffusion restriction on magnetic resonance imaging in prion diseases reflects spongiform degeneration and brain perfusion SPECT reveals hypoperfusion in the same areas. Brain perfusion SPECT findings in dementia should be carefully interpreted considering background pathology.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Jpn J Radiol Asunto de la revista: DIAGNOSTICO POR IMAGEM / RADIOLOGIA / RADIOTERAPIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Jpn J Radiol Asunto de la revista: DIAGNOSTICO POR IMAGEM / RADIOLOGIA / RADIOTERAPIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón