CT and MRI rating of white matter changes

Kapeller, Peter; Schmidt, R.; Enzinger, C; Ropele, Stefan; Fazekas, Franz

doi:10.1007/978-3-7091-6139-5_3

Cited by 12 publications

(12 citation statements)

References 12 publications

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“… * Periventricular capping and patchy deep white matter hyperintensities (Fazekas Grade 1), 24 1 to 2 lacunes, or both. …”

Section: Resultsmentioning

confidence: 99%

“…The MRI dementia protocol included sagittal and axial T1 images; axial T2, fluid attenuation inversion recovery, and diffusion‐weighted images; and coronal 3D fast spoiled gradient echo images. MRI scans were evaluated for micro‐ and macrovascular disease (3‐point Fazekas scale: mild, moderate, or severe 24 ) and morphological abnormalities (e.g., lobar atrophy and ventricular enlargement). Herein, CVD includes multiple etiologies including microvascular ischemic disease, lacunes, and lesions consistent with cerebral amyloid angiopathy 25 .…”

Section: Methodsmentioning

confidence: 99%

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Neuroimaging in the Clinical Diagnosis of Dementia: Observations from a Memory Disorders Clinic

Borghesani

DeMers

Manchanda

et al. 2010

J American Geriatrics Society

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OBJECTIVES To determine how often neuroimaging confirms, clarifies, or contradicts initial diagnoses of late life cognitive disorders. DESIGN Retrospective case review. SETTING An outpatient clinic specializing in memory disorders. PARTICIPANTS 193 consecutively referred, cognitively impaired patients. MEASUREMENTS Diagnoses using research criteria were developed for each patient at the first visit, and ranged from cognitive impairment without dementia to dementias of single, complex, or indeterminate etiology. Structural (non-contrast MRI) and perfusion (Tc-99m ECD SPECT) images were categorized together as normal, suggestive of specific diseases, or abnormal/not diagnostic. RESULTS When a single neurodegenerative disease was suspected clinically (n=94) imaging confirmed the diagnosis in 50, contradicted the diagnosis in 32, and was abnormal/not diagnostic in 12. When more than one neurodegenerative etiology was clinically suspected (n=21) imaging assigned a single diagnosis in 13 and only cerebrovascular disease in 1, and was abnormal/not diagnostic in 7. In dementia NOS (n=33), imaging suggested a specific etiology in 23 and was abnormal/not diagnostic in 10. Abnormal/not diagnostic images were more common in cognitive disorder NOS (n=25) than in other clinical groups (68% vs. 22%, χ2 = 22.8 p < 0.001). Neuroimaging indicators of cerebrovascular disease were common (60% prevalence) but not predicted by the presence of vascular risk factors alone. CONCLUSION Overall, neuroimaging confirmed, clarified, or contradicted the initial clinical diagnosis in >80% of patients while < 20% had abnormal/not diagnostic patterns. Imaging suggested a complex dementia etiology in 21% of cases clinically thought to be caused by a single process, while 46% of complex clinical differential diagnoses appeared to reflect a single causal pattern. Further work is needed to determine whether refinement of clinical diagnoses by specialized neuroimaging improves clinical decision-making and patient outcomes.

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“… * Periventricular capping and patchy deep white matter hyperintensities (Fazekas Grade 1), 24 1 to 2 lacunes, or both. …”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Neuroimaging in the Clinical Diagnosis of Dementia: Observations from a Memory Disorders Clinic

Borghesani

DeMers

Manchanda

et al. 2010

J American Geriatrics Society

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“…They are found primarily in the periventricular white matter (WM) and increase with age, cognitive impairment and depression (Schmahmann et al, 2008). A number of studies have recently focused on the connection between amount and location of WMH and these clinical symptoms and several employed visual scales to rate WMH (Kapeller et al, 2002;Prins et al, 2004;Scheltens et al, 1993;Wahlund et al, 2001). These scales estimate the lesion severity rather than explicitly detecting every single lesion and therefore entail a loss of information.…”

Section: Introductionmentioning

confidence: 99%

A comparison of different automated methods for the detection of white matter lesions in MRI data

et al. 2011

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“…The exact boundaries, if any, between AD + CVD and VD are, however, uncertain. Indeed, this subgroup may include different degrees of vascular damage (see [13,14] as reviews of recent CT and MRI scaling). The present study focuses on the CSF profile of two sub-populations of patients, classified as probable AD due to progressive and diffuse cognitive decline, but distinguished by different MRI findings: the former subgroup did not show significant white matter changes (WMC), while the latter showed ''infra-clinical'' MRIpositive vascular lesions.…”

Section: Introductionmentioning

confidence: 98%

AD with subcortical white matter lesions and vascular dementia: CSF markers for differential diagnosis

Stefani

Bernardini

Panella

et al. 2005

Journal of the Neurological Sciences

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CT and MRI rating of white matter changes

Cited by 12 publications

References 12 publications

Neuroimaging in the Clinical Diagnosis of Dementia: Observations from a Memory Disorders Clinic

Neuroimaging in the Clinical Diagnosis of Dementia: Observations from a Memory Disorders Clinic

A comparison of different automated methods for the detection of white matter lesions in MRI data

AD with subcortical white matter lesions and vascular dementia: CSF markers for differential diagnosis

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