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Use of significance image to determine patterns of cortical blood flow abnormality in pathological and at-risk groups
A S Houston1, P M Kemp, M A Macleod
1Department of Nuclear Medicine, Royal Hospital Haslar, Gosport, Hants, United Kingdom.
Insights
This study reveals distinct regional cerebral blood flow (rCBF) patterns in neurological conditions like Alzheimer's disease and decompression illness. These findings highlight abnormal blood flow as a key indicator for neurological damage assessment.
Area of Science:
- Neurology
- Medical Imaging
- Neuroscience
Background:
- Assessing neurological damage often involves evaluating regional cerebral blood flow (rCBF).
- Distinct rCBF patterns may indicate specific pathological groups or those at risk for neurological damage.
Purpose of the Study:
- To determine if pathological and at-risk groups exhibit unique rCBF abnormality patterns.
- To investigate the utility of significance imaging in visualizing these rCBF differences.
Main Methods:
- HMPAO SPECT images were acquired from six groups: normal volunteers, diver controls, divers with decompression illness (DCI), boxers, schizophrenics, and Alzheimer's disease patients.
- Multivariate, voxel-by-voxel comparison with a normal cortical rCBF atlas was performed.
- Significance images highlighted voxels with significant rCBF deficits (≥3 s.d. of normal).
Main Results:
- Significant differences in the percentage of abnormal cortical voxels and lesion patterns were observed across groups.
- Alzheimer's disease patients showed the highest percentage of abnormal voxels (2.24%) and lesions.
- Lesion locations varied, with Alzheimer's disease predominantly in parietal/inferior temporal regions, DCI/boxers in parietal/occipital, and schizophrenia in the inferior frontal lobe.
Conclusions:
- The study confirms that different pathological and at-risk groups display distinct rCBF patterns.
- Significance imaging is an effective method for demonstrating these rCBF abnormalities and aiding in differential diagnosis.
Unlabelled:
The purpose of this work was to determine whether certain pathological groups and other groups at risk for neurological damage exhibited distinctive patterns of regional cerebral blood flow (rCBF) abnormality.
Methods:
HMPAO SPECT images obtained from six groups of subjects were compared with a normal cortical rCBF atlas, based on multivariate, voxel-by-voxel methods. In each case, a significance image was outputted, highlighting voxels with deficits of > or =3 s.d. of normal. Abnormal patterns were examined for the six groups, which comprised a further 40 normal volunteers, 18 diver controls, 50 divers with decompression illness (DCI), 34 boxers, 23 schizophrenics and 21 subjects with Alzheimer's disease.
Results:
The percentages of abnormal cortical voxels for each group were 0.41%, 0.53%, 1.38%, 1.05%, 0.56% and 2.24%, respectively. The percentages of images in each group with at least one lesion of 10 or more connected abnormal voxels and at least 10 lesions of two or more connected voxels, respectively, were 8% and 8% (normal volunteers), 17% and 11% (diver controls), 38% and 38% (divers with DCI), 41% and 29% (boxers), 26% and 13% (schizophrenics) and 90% and 48% (subjects with Alzheimer's disease). This suggests that multiple small lesions are as common as single large lesions for divers with DCI but not for patients with Alzheimer's disease or schizophrenia. Large lesions are located predominantly in the parietal and inferior temporal regions for Alzheimer's disease, in the parietal and occipital regions for divers with DCI and boxers and in the inferior frontal region for schizophrenia.
Conclusion:
It appears that the groups considered here do have different rCBF patterns and that the significance image is a useful way of demonstrating this fact.