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Free Content Neuroimaging Findings in the Evaluation of Dementia: A Review

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Dementia is defined as a decline in mental abilities severe enough to interfere with normal everyday activities. It is a generic term that encompasses a wide spectrum of clinical signs and symptoms, and can be caused by various etiologies, which include neurodegenerative processes, infections, intracranial hemorrhages, hydrocephalus, vascular etiologies, and certain genetic mutations. An accurate diagnosis of the underlying etiology can be challenging and relies on correlating the clinical and neuroimaging findings, which often requires invasive procedures for a definitive diagnosis. Overlapping clinical symptoms in certain types of dementias can make it especially difficult to make the correct diagnosis; imaging plays a critical role in these cases. This article describes the characteristic neuroimaging findings seen in common and some less common causes of dementia. When considered in the appropriate clinical context, the high sensitivity and specificity of these imaging findings allow for an early and accurate noninvasive diagnosis of the specific type of dementia.

Learning Objective: Describe the salient neuroimaging findings that distinguish the different types of dementia discussed in the article.
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Keywords: AD = Alzheimer disease; ADC = apparent diffusion coefficient; APD = atypical parkinsonian disorder; CAA = cerebral amyloid angiopathy; CADASIL = cerebral autosomal dominant arteriopathy with subcortical infarctions and leukoencephalopathy; CJD = Creutzfeldt-Jakob disease; CSF = cerebrospinal fluid; CT = computed tomography; DLB = dementia with Lewy bodies; DTI = diffusion tensor imaging; DWI = diffusion-weighted imaging; DaTscan = iodine 123 3-fluoropropyl-2-beta-carbomethoxy-3-beta(4-iodophenyl) nortropane; FDG = fluorodeoxyglucose; FLAIR = fluid attenuated inversion recovery; FP-CIT = fluoropropyl-2-beta-carbomethoxy-3-beta(4-iodophenyl) nortropane; FTD = frontotemporal dementia; GRE = gradient recalled echo; L-Dopa = levodopa; MCI = mild cognitive impairment; MRPI = magnetic resonance parkinsonism index; MSA = multisystem atrophy; MSA-c = multisystem atrophy predominant cerebellar; MSA-p = multisystem atrophy predominant parkinsonism; NPH = normal pressure hydrocephalus; PD = Parkinson disease; PET = positron emission tomography; PPA = primary progressive aphasia; PSP = progressive supranuclear palsy; SN = substantia nigra; SPECT; SPECT = single-photon emission computed tomography; SS = superficial siderosis; SWI = susceptibility-weighted imaging; cSS = cortical superficial siderosis; sCJD = sporadic Creutzfeldt-Jakob disease; vCJD = variant Creutzfeldt-Jakob disease

Document Type: Research Article

Publication date: 01 November 2017

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  • Neurographics is the peer-reviewed, bimonthly educational journal of the American Society of Neuroradiology. The journal comprises articles selected from material presented at the ASNR Annual Meeting. Neurographics also publishes other high-quality submissions that are primarily educational and have a high emphasis on a pictorial approach. Neurographics offers CME credit for reading review articles and completing quiz-based self-assessment activities. CME credit for review articles may be claimed up to 3 years after an article's publication date. Visit to view all available CME courses.
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