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    IMAGING IN ALZHEIMER'S
    Expanding use beyond diagnosis

    Physicians describe the diagnosis of Alzheimer's disease as a process of elimination. Doctors must rely on a detailed medical history of the person, complete physical and neurological examinations, psychiatric assessment and laboratory tests to establish the diagnosis of dementia of the Alzheimer's type. Computed tomography (CT) scanning or a magnetic resonance imaging (MRI) examination of the head often are used as diagnostic aids to rule out strokes, tumors and other conditions. Together, these methods enable physicians to accurately diagnose 90 percent of dementias.

    While medical experts agree that the only sure way to make a definitive diagnosis of Alzheimer's disease is by autopsy, imaging techniques such as CT and MRI are seen as important diagnostic tests and as increasingly useful research tools in detecting changes in brain anatomy and function.

    The foundation of imaging research

    There is no question that imaging techniques are capable of detecting and measuring changes in the brain of many people suspected of having Alzheimer's. However, at present there are no standard criteria for the use of CT or MRI in diagnosing this disease.

    Accomplishing this goal requires two classes of imaging research: cross-sectional imaging, which is a one-time scan, and serial measurements, which are multiple images of an individual's brain collected and compared over time.

    Studying how the brain looks

    MRI is an imaging technology that visualizes the form and structure of the brain. A computer creates tissue slice images from data generated by a magnetic field and radio waves. In some cases, a contrast agent is injected in a vein to enhance these images. Mayo Clinic researchers have used MRI to investigate the measurement of brain volume, specifically of the hippocampus, an area important to memory function and a site of the early development of the microscopic neurofibrillary tangles of thread-like nerve fibers in the brain characteristic of Alzheimer's disease.

    Such research helped Mayo Clinic investigators identify a transitional state of memory loss known as Mild Cognitive Impairment (MCI) that may signal Alzheimer's disease. People with MCI have forgetfulness beyond what one would expect for their age, but have not been diagnosed with Alzheimer's disease. This distinction may help physicians more accurately diagnose and advise patients who are at increased risk of Alzheimer's.



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