[Microangiopathic lesions of white matter. Quantitation of cerebral MRI findings and correlation with psychological tests].
OBJECTIVE
The importance of vascular lesions in the white matter of the brain (WML) is viewed differently. Diagnostic evaluation is determined by experience and age-associated normal values are not available.


METHODS
One hundred fifty-two patients aged 68.8 years (range 50-89) were examined at a memory clinic using a magnetic resonance FLAIR sequence,which is sensitive for WML. The WMLs were entered with respect to size, localization, laterality, and density. The WML scores of 76 clinically and psychologically normal subjects with microangiopathic lesions and 27 patients with vascular dementia were correlated with psychological test results. The contribution of local WML scores to the differentiation between age-associated microangiopathy and vascular dementia was calculated using logistic regression analysis. Nonparametric monotonic regression was used to analyse the age-associated WML scores of both groups, taking individual age into account.


RESULTS
The WML scores correlated linearly with the age of psychologically normal subjects but with degree of dementia for those with vascular dementia, and it allowed differentiation between these two groups with an accuracy of up to 88% and specificity of approximately 95% with reference to the right frontal region. The odds ratios of the general and frontal WML scores were significantly different (1,102 and 1,400, respectively). Statistical significance of the age-associated WML scores varied for different age ranges.


CONCLUSIONS
It is possible to differentiate psychologically normal subjects with microangiopathic brain lesions from patients with vascular dementia on MRI when referring to frontal WML scores.
Hentschel
F
F
Abt. Neuroradiologie, Zentralinstitut für seelische Gesundheit, Fakultät für klinische Medizin Mannheim der Universität Heidelberg. hentsche@zi-mannheim.de
Kreis
M
M
Damian
M
M
Krumm
B
B
D000368:Aged; D000369:Aged, 80 and over; D000679:Amygdala / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000523:psychology; D002540:Cerebral Cortex / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D012680:Sensitivity and Specificity
Mikroangiopathische Läsionen der weissen Hirnsubstanz. Quantifizierung im MRT und Korrelation mit psychologischen Testergebnissen.