Bildgebung bei Demenz

Zusammenfassung

Mit der zunehmenden Überalterung der Gesellschaft wird die Demenz zukünftig auch den Radiologen “beschäftigen”. Hauptindikation für die Bildgebung ist der Ausschluss einer unerwarteten und behandelbaren Ursache. Hierbei weisen seltene Demenzerkrankungen pathognomonische MRT-Muster auf und sollten zuverlässig erkannt werden. In der Diagnostik ist der Morbus Alzheimer mit 60% die häufigste Demenzerkrankung und das MRT neben Liquor und PET bzw. SPECT ein Biomarker. Eine auf senkrecht zur C.a.C.p.-Ebene quantifizierte temporomesiale Atrophie ist bei nicht symptomatischen Patienten prädiktiv für das rasche Auftreten von Symptomen. Für die Erfassung geringer Volumenveränderungen im Verlauf ist die visuelle Analyse unzureichend; voxelbasierte Analyseverfahren sollten herangezogen werden.

Summary

With the ageing of our population dementia will become a relevant topic for radiologist. To date, the key clinical indication for imaging studies is the exclusion of unexpected but treatable conditions. Some types of dementia have characteristic patterns on MR images, which should be readily recognized by the radiologist. MRI together with CSF, PET and SPECT is considered a biomarker in the diagnosis of Alzheimer’s disease, the most frequent dementia affecting approximately 60% of patients with dementia. Atrophy of the mesial temporal lobe quantified on images acquired perpendicular to a plane defined by the anterior and posterior commissure predicts the rapid development of symptoms in otherwise asymptomatic patients. However, the detection of small changes in brain volume during follow-up imaging requires a voxel based analysis.

Schlüsselwörter

Demenz - Atrophie - M. Alzheimer - Amyloid - frontotemporale Lobärdegeneration

Keywords

Dementia - atrophy - Alzheimer - amyloid - frontotemporal lobar degeneration

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