Evidence-based evaluation of magnetic resonance imaging as a diagnostic tool in dementia workup.
BACKGROUND
The diagnostic utility of magnetic resonance imaging in dementia workups has increased recently. The basic use is to exclude space-occupying processes in the brain. However, magnetic resonance imaging offers major opportunities for studying atrophy of specific brain areas. A great interest has been put in whether atrophy in the medial temporal lobe can serve as an early diagnostic marker for Alzheimer disease.


RESULTS
In this evaluation, we used evidence-based techniques and reviewed more than 400 articles that address this issue. Our main finding is that a variety of methods in studying brain areas were used, and this made it difficult to extract conclusive information in a systematic way.


CONCLUSIONS
However, we were able to conclude that atrophy of the hippocampus can distinguish patients with Alzheimer disease from healthy subjects, but there was a lack of evidence because of insufficient studies concerning the usefulness of medial temporal lobe atrophy as a diagnostic marker in a more general setting.
Wahlund
Lars-Olof
LO
Department of Neurobiology, Caring Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden. lars-olof.wahlund@ki.se
Almkvist
Ove
O
Blennow
Kaj
K
Engedahl
Knut
K
Johansson
Aki
A
Waldemar
Gunhild
G
Wolf
Henrike
H
D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity