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認知症の原因は,アルツハイマー病(Alzheimer’s disease:AD),レビー小体型認知症(dementia with Lewy bodies:DLB),嗜銀顆粒性認知症(argyrophilic grain disease:AGD),進行性核上性麻痺(progressive supranuclear palsy:PSP),大脳皮質基底核変性症(corticobasal degeneration:CBD)などの神経変性疾患に加え,脳血管障害,腫瘍,内分泌・代謝異常,感染症,特発性正常圧水頭症(idiopathic normal pressure hydrocephalus:iNPH)など多彩である。ゆえに,MRIによる画像診断では,読影による異常所見の検出に加え,これらの多彩な病態の診断に寄与しうる画像所見を捉えうるシーケンスの撮像が画像診断医に要求される。本稿では,MRIの撮像法や画像診断の基礎を述べる総論,代表的な認知症性疾患の画像所見を述べる各論に分けて,認知症の画像診断におけるMRIの有用性を解説する。
As well as clinical symptoms and assessment, structural magnetic resonance imaging(MRI)is one of the useful imaging modalities to diagnose demented patients. However, to diagnose various kinds of disorders including neurodegenerative diseases, cerebrovascular diseases, neoplasms, metabolic diseases and infectious diseases which can cause dementia, it is mandatory to perform the adequate MRI examinations and diagnosis methods. In this article, authors explain the basis of MRI techniques and characteristic imaging findings of the representative disorders for the educational purpose.
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