Purpose

The Cingulate Island Sign score (CIScore) by rCBF SPECT is used in the differentiation between Dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD) but has some false-positive AD cases. To resolve the problem, we developed new differential diagnosing method incorporating occipital lobe and para-hippocampal rCBF.

Materials and methods

In 27 DLB and 31 AD cases undertaken Tc-99 m-ECD SPECT, we evaluated the mean Z score in the bilateral superior, middle, inferior occipital gyri, cuneus, amygdala, hippocampus, and para-hippocampus. One criterion of DLB was defined as the case with CIScore lower than 0.27. The other criteria were the cases of following either or both two conditions were satisfied. (1) The number of occipital gyri with mean Z score higher than 1 is three or more. (2) The number of hippocampal regions with mean Z score higher than 1 is one or less. We compared the differential diagnostic ability among these four criterions.

Results

The diagnostic accuracy by CIscore was 69% and that of the occipital gyri analysis 84%, para-hippocampal regions analysis 76% and combined occipital gyri and para-hippocampal regions analysis 93%.

Conclusion

The new method by combined rCBF analysis of occipital gyri and para-hippocampal regions showed best diagnostic ability in differentiating DLB from AD.

中文翻译：

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通过脑灌注SPECT与CIScore的比较来开发区分路易体痴呆和阿尔茨海默氏病的新方法。

目的

rCBF SPECT的Cingulate Island Sign评分（CIScore）用于区分路易体痴呆（DLB）和阿尔茨海默氏病（AD），但有一些假阳性AD病例。为了解决该问题，我们开发了一种结合枕叶和海马旁rCBF的新的鉴别诊断方法。

材料和方法

在接受Tc-99 m-ECD SPECT的27例DLB和31例AD患者中，我们评估了双侧上，中，枕下回，腓骨，杏仁核，海马和海马旁的Z值。DLB的一项标准被定义为CIScore低于0.27的情况。其他标准是满足以下两个条件之一或两个都满足的情况。（1）Z均值大于1的枕回数为3个以上。（2）平均Z评分高于1的海马区数量为1个或更少。我们比较了这四个标准中的鉴别诊断能力。

结果

CIscore的诊断准确度为69％，枕回的分析准确率为84％，海马旁的分析为76％，枕回和海马旁的合并分析为93％。

结论

通过枕叶回和海马旁区域的rCBF组合分析的新方法在区分DLB和AD方面显示出最佳的诊断能力。