Brain atrophy in neurodegenerative diseases. Quantitative and qualitative CT analysis

A quantitative and qualitative analysis was done of 187 CT examinations in 59 healthy subjects and 128 patients with various neurodegenerative diseases. The rates of agreement between quantitative measurements and the qualitative grading by two observers were 76.7% for the evaluation of lateral ventricular size and 66.3% for the assessment of sulcal size. Increase in the width of the 3rd ventricle, in the bi-caudate span, and in the area of the lateral ventricles reflected a pathologic enlargement of the ventricles. The profile of ventricular dilatation in dementia patients was different from that of other patients with brain atrophy. However, the quantitative measurement of brain atrophy by a computer-based method did not increase the differential diagnostic accuracy among dementia patients. The results stress the importance of the selection of valid measures in the evaluation of structural changes of the brain. We suggest the use of reference scans for improving the reliability of the visual evaluation.