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State of the Art |
1 From the Departments of Radiology (J.R.P., R.E.C.) and Geriatric Medicine and Psychiatry (P.M.D.), Duke University Medical Center, Duke Hospital North, Rm 1513, Erwin Rd, Durham, NC 27710. Received September 28, 2001; revision requested December 3; revision received February 25, 2002; accepted March 14. J.R.P. supported by grants from the RSNA Research and Education Foundation and the National Institute of Aging (R01AG019728-01). P.M.D. supported by grants from the American Federation of Aging Research and the National Institutes of Health. Address correspondence to J.R.P. (e-mail: jeffrey.petrella@duke.edu).
Alzheimer disease (AD), a progressive neurodegenerative disorder, is the most common cause of dementia in the elderly. Current consensus statements have emphasized the need for early recognition and the fact that a diagnosis of AD can be made with high accuracy by using clinical, neuropsychologic, and imaging assessments. Magnetic resonance (MR) or computed tomographic (CT) imaging is recommended for the routine evaluation of AD. Coronal MR images can be useful to document or quantify atrophy of the hippocampus and entorhinal cortex, both of which occur early in the disease process. Both volumetric and subtraction MR techniques can be used to quantify and monitor dementia progression and rates of regional atrophy. MR measures are also increasingly being used to monitor treatment effects in clinical trials of cognitive enhancers and antidementia agents. Positron emission tomography (PET) and single photon emission CT offer value in the differential diagnosis of AD from other cortical and subcortical dementias and may also offer prognostic value. In addition, PET studies have demonstrated that subtle abnormalities may be apparent in the prodromal stages of AD and in subjects who carry susceptibility genes. PET ligands are in late-stage development for demonstration of amyloid plaques, and human studies have already begun. Functional MR–based memory challenge tests are in development as well.
© RSNA, 2003
Index terms: Alzheimer disease, 13.83 • Brain, CT, 13.12111 • Brain, function • Brain, MR, 13.121411, 13.121412, 13.121416, 13.12144, 13.12145 • Brain, radionuclide studies, 13.12162, 13.12163 • State of the Art
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