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Radiology, Vol 195, 65-72, Copyright © 1995 by Radiological Society of North America

ARTICLES

Probable Alzheimer disease: diagnosis with proton MR spectroscopy

TK Shonk, RA Moats, P Gifford, T Michaelis, JC Mandigo, J Izumi and BD Ross
Magnetic Resonance Spectroscopy Unit, Huntington Medical Research Institutes, Pasadena, CA 91105.

PURPOSE: To distinguish probable Alzheimer disease (AD) from other dementias (ODs) and normality in the elderly. MATERIALS AND METHODS: A double-blind trial of proton magnetic resonance (MR) spectroscopy was performed, principally in gray matter, in the occipital cortex of 114 patients with dementia (AD [n = 65], OD [n = 39], or frontal lobe dementia [FLD] [n = 10]), 98 patients without dementia, and 32 healthy control subjects. RESULTS: Reduced levels of N-acetylaspartate (NAA) (P < .0005) and increased levels of myo-inositol (MI) (P < .0005) characterize AD. Patients with OD had significantly reduced levels of NAA (P < .01) but normal levels of MI (P [vs AD] < .0005). When MI/NAA was used, AD was distinguished from normality with 83% sensitivity and 98% specificity. When MI/creatine was used, OD was distinguished from AD and FLD with a negative predictive rate of 80%, sensitivity of 82%, and specificity of 64%. CONCLUSION: Hydrogen-1 MR spectroscopy enables identification of mild to moderate AD with a specificity and sensitivity that suggest clinical utility.


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