Vol 1, No 1 (1998)
Original articles
Published online: 2000-02-10
Submitted: 2012-01-23
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rCBF SPECT and the acetazolamide test in the evaluation of dementia

Laszlo Pavics, Frank Grunwald, Karl Reichmann, Terez Sera, Edit Ambrus, Rolf Horn, Alexander Hartmann, Christian Menzel, Laszlo Csernay, Hans J. Biersack
Nucl. Med. Rev 1998;1(1):13-19.
Vol 1, No 1 (1998)
Original articles
Published online: 2000-02-10
Submitted: 2012-01-23

Abstract

Background: The diagnostic potential of 99mTc-HMPAO following systemic administration of the cerebral vasodilator acetazolamide (acetazolamide test) was evaluated using regional-cerebral-blood-flow (rCBF) SPECT in patients with Alzheimer's disease (AD) or with vascular-type of dementia (VD).
Methods: An initial, high-resolution SPELT study was performed with 99mTc-HMPAO, and after 2 days patients were re-evaluated with 99mTc-HMPAO following systemic administration of acetazolamide. Reconstructed SPELT slices were evaluated visually and semiquantitatively by a semiautomatic rCBF map method.
Results: Using 99mTc-HMPAO alone, a bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of VD patients and in 70% (23/33) of AD patients. The vascular reserve capacity, as determined with the acetazolamide test, was not impaired in 22% of the VD patients but in 76% of the AD patients. The differences in the perfusion patterns between VD and AD patients were statistically different (p < 0.01, Fischer's exact test). Of the 6 VD patients with hypoperfusion (bilateral temporal and/or parietal), 4 had a decreased vascular reserve capacity as determined in the acetazolamide test. Decreased reserve capacity was found in only 4 out of 25 patients with AD.
Conclusions : The acetazolamide test is helpful in rCBF SPECT to differentiate VD from AD.

Abstract

Background: The diagnostic potential of 99mTc-HMPAO following systemic administration of the cerebral vasodilator acetazolamide (acetazolamide test) was evaluated using regional-cerebral-blood-flow (rCBF) SPECT in patients with Alzheimer's disease (AD) or with vascular-type of dementia (VD).
Methods: An initial, high-resolution SPELT study was performed with 99mTc-HMPAO, and after 2 days patients were re-evaluated with 99mTc-HMPAO following systemic administration of acetazolamide. Reconstructed SPELT slices were evaluated visually and semiquantitatively by a semiautomatic rCBF map method.
Results: Using 99mTc-HMPAO alone, a bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of VD patients and in 70% (23/33) of AD patients. The vascular reserve capacity, as determined with the acetazolamide test, was not impaired in 22% of the VD patients but in 76% of the AD patients. The differences in the perfusion patterns between VD and AD patients were statistically different (p < 0.01, Fischer's exact test). Of the 6 VD patients with hypoperfusion (bilateral temporal and/or parietal), 4 had a decreased vascular reserve capacity as determined in the acetazolamide test. Decreased reserve capacity was found in only 4 out of 25 patients with AD.
Conclusions : The acetazolamide test is helpful in rCBF SPECT to differentiate VD from AD.
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Keywords

rCBF SPECT; 99mTc-HMPAO; acetazolamide test; Alzheimer' s disease; vascular dementia

About this article
Title

rCBF SPECT and the acetazolamide test in the evaluation of dementia

Journal

Nuclear Medicine Review

Issue

Vol 1, No 1 (1998)

Pages

13-19

Published online

2000-02-10

Bibliographic record

Nucl. Med. Rev 1998;1(1):13-19.

Keywords

rCBF SPECT
99mTc-HMPAO
acetazolamide test
Alzheimer's disease
vascular dementia

Authors

Laszlo Pavics
Frank Grunwald
Karl Reichmann
Terez Sera
Edit Ambrus
Rolf Horn
Alexander Hartmann
Christian Menzel
Laszlo Csernay
Hans J. Biersack

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