2019 年 36 巻 4 号 p. 380-383
The role of imaging in diagnosing neurodegenerative disorders have been increasing its importance. By combing the results of brain magnetic resonance image (MRI) and nuclear images, clinicians can not only increase the diagnostic assurance, but may also trigger alternative diagnosis when the result was an unexpected one.
In brain MRI, ischemic change, hemorrhagic regions as well as local atrophy are visually assessed. Single case voxel–based morphometry can be performed by VSRAD® as for adjunct diagnostic tool. Diffusion weighted images may be able to diagnose Creutzfeldt–Jakob disease and Neuronal intranuclear inclusion disease, and Adult–onset leukoencephalopathy with axonal spheroids and pigmented glia. Nigrosome–1 can be visualized by susceptibility weighted image and may help diagnose parkinsonian disorders.
Perfusion images may reflect local ischemia, atrophy and neuronal activities and should be visually assessed with corresponding brain MRI. It is useful diagnostic tool for dementia and parkinsonian disorders. Neurotransmitter images such as dopamine transporter image which captures nigrostriatal presynaptic dopaminergic function and sympathetic myocardiac image may each give a clue to certain diagnosis of neurodegenerative disorders, and should be tested for narrowing down the estimated differential diagnoses, not for routine screening purpose.
