F Hentschel1, M Kreis, M Damian, B Krumm. 1. Abt. Neuroradiologie, Zentralinstitut für seelische Gesundheit, Fakultät für klinische Medizin Mannheim der Universität Heidelberg. hentsche@zi-mannheim.de
Abstract
AIM: The importance of vascular lesions in the white matter of the brain (WML) is viewed differently. Diagnostic evaluation is determined by experience and age-associated normal values are not available. MATERIAL AND METHODS: One hundred fifty-two patients aged 68.8 years (range 50-89) were examined at a memory clinic using a magnetic resonance FLAIR sequence,which is sensitive for WML. The WMLs were entered with respect to size, localization, laterality, and density. The WML scores of 76 clinically and psychologically normal subjects with microangiopathic lesions and 27 patients with vascular dementia were correlated with psychological test results. The contribution of local WML scores to the differentiation between age-associated microangiopathy and vascular dementia was calculated using logistic regression analysis. Nonparametric monotonic regression was used to analyse the age-associated WML scores of both groups, taking individual age into account. RESULTS: The WML scores correlated linearly with the age of psychologically normal subjects but with degree of dementia for those with vascular dementia, and it allowed differentiation between these two groups with an accuracy of up to 88% and specificity of approximately 95% with reference to the right frontal region. The odds ratios of the general and frontal WML scores were significantly different (1,102 and 1,400, respectively). Statistical significance of the age-associated WML scores varied for different age ranges. CONCLUSION: It is possible to differentiate psychologically normal subjects with microangiopathic brain lesions from patients with vascular dementia on MRI when referring to frontal WML scores.
AIM: The importance of vascular lesions in the white matter of the brain (WML) is viewed differently. Diagnostic evaluation is determined by experience and age-associated normal values are not available. MATERIAL AND METHODS: One hundred fifty-two patients aged 68.8 years (range 50-89) were examined at a memory clinic using a magnetic resonance FLAIR sequence,which is sensitive for WML. The WMLs were entered with respect to size, localization, laterality, and density. The WML scores of 76 clinically and psychologically normal subjects with microangiopathic lesions and 27 patients with vascular dementia were correlated with psychological test results. The contribution of local WML scores to the differentiation between age-associated microangiopathy and vascular dementia was calculated using logistic regression analysis. Nonparametric monotonic regression was used to analyse the age-associated WML scores of both groups, taking individual age into account. RESULTS: The WML scores correlated linearly with the age of psychologically normal subjects but with degree of dementia for those with vascular dementia, and it allowed differentiation between these two groups with an accuracy of up to 88% and specificity of approximately 95% with reference to the right frontal region. The odds ratios of the general and frontal WML scores were significantly different (1,102 and 1,400, respectively). Statistical significance of the age-associated WML scores varied for different age ranges. CONCLUSION: It is possible to differentiate psychologically normal subjects with microangiopathic brain lesions from patients with vascular dementia on MRI when referring to frontal WML scores.
Authors: Tufail F Patankar; Dipayan Mitra; Anoop Varma; Julie Snowden; David Neary; Alan Jackson Journal: AJNR Am J Neuroradiol Date: 2005 Jun-Jul Impact factor: 3.825