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Dementia MRI evaluation- Is it Alzeimer's?

This is a 68 year old female with history of memory loss and depression with significant temporal atrophy along with some parietal lobe atrophy. Not much white matter lacunar lesions. Alzeimers is suspected. Some signs of specific dementias on MRI to be looked for are:

  • Alzheimer's disease (AD): medial temporal lobe atrophy (MTA) and parietal atrophy.
  • Frontotemporal Lobar Degeneration (FTLD): (asymmetric) frontal lobe atrophy and atrophy of the temporal pole.
  • Vascular Dementia (VaD): global atrophy, diffuse white matter lesions, lacunes and 'strategic infarcts' (infarcts in regions that are involved in cognitive function).
  • Dementia with Lewy bodies (DLB): in contrast to other forms of dementia usually no specific abnormalities.

MTA-scale for Medial Temporal lobe Atrophy

The MTA-score should be rated on coronal T1-weighted images at a consistent slice position.
Select a slice through the corpus of the hippocampus, at the level of the anterior pons.

The score is based on a visual rating of the width of the choroid fissure, the width of the temporal horn, and the height of the hippocampal formation.

score 0: no atrophy
score 1: only widening of choroid fissure
score 2: also widening of temporal horn of lateral ventricle
score 3: moderate loss of hippocampal volume (decrease in height)
score 4: severe volume loss of hippocampus

< 75 years: score 2 or more is abnormal.
> 75 years: score 3 or more is abnormal.
Dementia MRI evaluation- Is it Alzeimer's? Reviewed by Sumer Sethi on Wednesday, November 27, 2013 Rating: 5

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