The purpose of this exhibit is to review the neuroimaging findings in the evaluation of cognitive impairment or dementia, with emphasis on the utility of MRI, and more specifically, the role of different established visual rating scales for specific brain regions.
We describe the MRI protocol for imaging of neurodegenerative diseases, focusing on the visual MRI rating scales available.
We review the most common atrophy patterns in the main entities presenting with dementia.
Dementia syndromes include a wide spectrum of diseases where clinical presentation and imaging findings are sometimes overlapping.
Brain imaging is recommended in all current diagnostic dementia guidelines. Recently they also recommend the application of atrophy rating scales to assess structural changes in the brain of elderly patients, such as the medial temporal lobe atrophy(Scheltens). However, there is still low uptake in routine clinical setting and knowledge of the neuroimaging strategies available and MRI rating scales is needed in order to encourage clinicians and radiologists to...
Findings and procedure details
Neuroimaging strategies in cognitive impairment and dementia
MRI is the primary imaging modality in neurodegenerative diseases to rule out other pathologies and to assess focal brain atrophy and white matter disease.
A brain MRI protocol including structural MRI and high spatial resolution anatomic images is recommended(Alzheimer Centre in Amsterdam)Fig. 2:
- Saggital T1 MPRAGE(magnetization prepared rapid acquisition gradient echo).
- Axial FLAIR(fluid-attenuated inversion recovery).
- Axial T2.
- Axial T2* or Susceptibility Weighted Images(SWI).
- Diffusion Weighted Images(DWI).
Multi-detector CT is used if there are...
Knowledge of the different patterns of brain atrophy according to the clinical presentation and the neuroimaging strategies available in a dementia clinical setting, including MRI rating scales, will help in making an accurate diagnosis and hence a proper patient management. We encourage radiologists to use them.Fig. 24,Fig. 25,Fig. 26
Personal information and conflict of interest
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