Medial temporal lobe atrophy is underreported and may have important clinical correlates in medical inpatients

BMC Geriatrics

Research Article

Lennart Minthon¹  Elisabet Londos¹  Gustav Torisson¹  Lars Stavenow²  Danielle van Westen³ 

[1] Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Lund, Sweden;Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden;Diagnostic Radiology, Clinical Sciences, Lund University, Lund, Sweden;Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden;

关键词: Dementia;    Neurodegenerative diseases;    Computerised tomography;    Inpatients;   

DOI  :  10.1186/s12877-015-0066-4

 received in 2015-01-20, accepted in 2015-05-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe diagnostic workup in dementia includes brain imaging with reading focussed on signs of cerebrovascular and neurodegenerative disease. We hypothesised that these findings may be underreported in hospital patients, where imaging is often performed to rule out obvious pathology such as haemorrhage. In this study, we review cranial computed tomography (CT) in medical inpatients for white matter changes and atrophy. Our aim was to determine the clinical relevance of such findings and to what extent they were underreported.MethodsRecords from 200 inpatients aged over 60 years, who had been subjected to MMSE (mini-mental state examination) and CDT (clock-drawing test), were reviewed for cranial CT. Transverse and coronal slices were reassessed using visual rating scales regarding white matter changes (WMC), global cortical atrophy (GCA) and medial temporal lobe atrophy (MTA). Findings were compared with the original radiology reports and cognitive test results.ResultsCranial CT had been performed in 94 of 200(47 %) patients. Of these, 58(62 %) had abnormal WMC, 35(37 %) abnormal GCA and 34(36 %) abnormal MTA. All three findings had associations with cognitive test results. Abnormal MTA was associated with lower results on the overall score on MMSE and on orientation, memory and language items. All three measurements were underreported in the original radiology reports; none of the 34 patients with abnormal MTA had been reported originally.ConclusionsSigns of neurodegenerative disease, especially MTA, were highly underreported in cranial CT scans performed in medical inpatients. At the same time, MTA seemed to hold the most important clinical correlates. Our results suggest that MTA should be reported more regularly in this setting.

【 授权许可】

CC BY   
© Torisson et al. 2015