The importance of brain SPECT cognitive disorders - comparison of clinical diagnosis and brain perfusion scintigraphy
Abstract
In this study the significance of Single Photon Emission Computed Tomography (SPECT) investigation was evaluated in patients with cognitive disorders. A retrospective analysis of data from patients investigated during 4 year period was made with the aim to compare the results of SPECT with clinical diagnosis.
Sixty eight patients with clinical diagnoses (33 patients with probable AD, 13 with mild cognitive deficit (MCI) and 20 individuals with other disorders) were classified into 5 major categories according to the second blind assessment of brain SPECT: AD perfusion pattern (19 patients), vascular dementia pattern (17), mixed dementia pattern (MIX) (18), other patterns (11) and normal one (3). Thirty-three patients with probable Alzheimer's disease were studied. 87% of them showed typical image of AD on SPECT scan and half of them showed an image of mixed type dementia.
In thirteen patients with mild cognitive impairment was found heterogeneous blood perfusion corresponding with miscellaneous population of patients with mild cognitive impairment (MCI). In 25 right-handed patients with the SPECT pattern suggestive of AD or MIX, temporoparietal or temporal hypoperfusion was detected in the first examination of these patients on the left in 60 %, on the right in 8 % and billaterally in 32 % of AD patients.
Reliability of radionuclid method was established as inter- (89%) and intrapersonal (87%) brain SPECT perfusion results equality. Brain SPECT may support the diagnosis of AD.
In addition, it may hint vascular changes in the brain. Heterogeneous patterns in patients with MCI reflect mixed population of MCI.