Sensitivity, specificity, and positive predictive value of technetium 99-HMPAO SPECT in discriminating Alzheimer's disease from other dementias

被引:52
作者
Masterman, DL [1 ]
Mendez, MF [1 ]
Fairbanks, LA [1 ]
Cummings, JL [1 ]
机构
[1] UNIV CALIF LOS ANGELES,DEPT PSYCHIAT & BIOBEHAV SCI,SCH MED,NEUROBEHAV UNIT,LOS ANGELES,CA 90095
关键词
D O I
10.1177/089198879701000104
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Investigators have reported high sensitivity and specificity values for single photon emission computerized tomography (SPECT) when distinguishing Alzheimer's disease (AD) patients from normal elderly controls or from selected patient groups. The role of SPECT in identifying AD among unselected patients with memory complaints requires investigation. We examined 139 consecutive patients with Tc-99-HMPAO SPECT. NINCDS-ADRDA diagnoses were determined blind to SPECT results, and scans were read and classified by visual inspection blind to clinical diagnoses. Bilateral temporoparietal hypoperfusion (TP) occurred in 75% of probable, 65% of possible, and 45% of unlikely AD patients, yielding a sensitivity of 75% and a specificity of 52% when comparing probable AD versus unlikely AD groups. A positive predictive value of 78% was obtained based on a 69% prevalence of AD in our total clinic population. Patients with false-positive results included a variety of dementing illnesses; all patients with bilateral hypoperfusion had dementia. A pattern of TP on SPECT scans is seen in most patients with AD, but could be found in other dementias as well and cannot be regarded as specific to AD. Reduced TP perfusion discriminated between demented and nondemented individuals. Further strategies for SPECT interpretation that improve diagnostic specificity should be sought.
引用
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页码:15 / 21
页数:7
相关论文
共 50 条
[1]  
BATTISTIN L, 1994, ARCH NEUROL-CHICAGO, V51, P1198
[2]  
BOLLER F, 1989, NEUROLOGY, V39, P76
[3]   BRAIN BLOOD-FLOW IN THE DEMENTIAS - SPECT WITH HISTOPATHOLOGIC CORRELATION [J].
BONTE, FJ ;
TINTNER, R ;
WEINER, MF ;
BIGIO, EH ;
WHITE, CL .
RADIOLOGY, 1993, 186 (02) :361-365
[4]   SINGLE PHOTON TOMOGRAPHY IN ALZHEIMERS-DISEASE AND THE DEMENTIAS [J].
BONTE, FJ ;
HOM, J ;
TINTNER, R ;
WEINER, MF .
SEMINARS IN NUCLEAR MEDICINE, 1990, 20 (04) :342-352
[5]   THE INVESTIGATION OF ALZHEIMERS-DISEASE WITH SINGLE PHOTON-EMISSION TOMOGRAPHY [J].
BURNS, A ;
PHILPOT, MP ;
COSTA, DC ;
ELL, PJ ;
LEVY, R .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1989, 52 (02) :248-253
[6]   THE DIAGNOSTIC-VALUE OF SPECT WITH TC-99M HMPAO IN ALZHEIMERS-DISEASE - A POPULATION-BASED STUDY [J].
CLAUS, JJ ;
VANHARSKAMP, F ;
BRETELER, MMB ;
KRENNING, EP ;
DEKONING, I ;
VANDERCAMMEN, TJM ;
HOFMAN, A ;
HASAN, D .
NEUROLOGY, 1994, 44 (03) :454-461
[7]  
COHEN MB, 1986, J NUCL MED, V27, P769
[8]   CEREBRAL BLOOD-FLOW IN SEVERITY-MATCHED ALZHEIMER AND MULTIINFARCT PATIENTS [J].
DEUTSCH, G ;
TWEEDY, JR .
NEUROLOGY, 1987, 37 (03) :431-438
[9]   POSITRON EMISSION TOMOGRAPHY IN ALZHEIMERS-DISEASE [J].
DUARA, R ;
GRADY, C ;
HAXBY, J ;
SUNDARAM, M ;
CUTLER, NR ;
HESTON, L ;
MOORE, A ;
SCHLAGETER, N ;
LARSON, S ;
RAPOPORT, SI .
NEUROLOGY, 1986, 36 (07) :879-887
[10]   REDUCED TEMPORAL-LOBE BLOOD-FLOW IN ALZHEIMERS-DISEASE [J].
EBERLING, JL ;
JAGUST, WJ ;
REED, BR ;
BAKER, MG .
NEUROBIOLOGY OF AGING, 1992, 13 (04) :483-491