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Alzheimer’s Disease in 73 yo with Memory Loss

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So this next patient, case number three, is a 73 year old with

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memory loss. They had an MRI of the brain in 2016.

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First, look at the DWI, there's no evidence of acute infarct, though we

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actually don't have a GRE sequence or a FLAIR sequence on this case

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because the patient was not able to tolerate finishing their MRI,

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but we do have a T2. And on that, we see that there's moderate

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to moderately severe cerebral atrophy with a right mesiotemporal predilection.

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We see the prominence and size here of the right temporal horn, and

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this is what the rest of the brain looks like. If you look

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here on the coronal images, these are the hippocampi, and we see the hippocampal

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atrophy bilaterally, particularly on the right hand side.

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There is moderate microvascular ischemic disease that we see here, T2 hyperintensity

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in the cerebral white matter. The patient also had an amyloid study in

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2016, and this is diffusely positive. So you see diffuse binding of the

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amyloid tracer throughout the cortex. The entire brain looks dark on amyloid.

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This is an evidently positive exam, which tells us that this patient does

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indeed have Alzheimer's. Okay, so case number three again is the 73 year

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old with memory loss. Here is the MRI in 2016, moderate to moderately severe

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atrophy with a right temporal predilection. The patient had quantitative

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volumetric imaging in 2016. There was some reduction in hippocampal volumes,

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but of note, there was statistically significant reduction in the HOC

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for the patient here. The icobrain also showed reduction of the

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hippocampal volumes and enlargement of the inferior lateral ventricles.

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You see here in this report that it's

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up here in the pink zone, indicating that the inferior lateral ventricles

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are significantly enlarged. This patient then had an amyloid PET in 2016.

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Here's the PET CT fusion images. Here's the PET MR fusion images.

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This is diffusely positive, so binding of that amyloid tracer throughout

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the cortex in this patient who has Alzheimer's disease.

Report

Faculty

Suzie Bash, MD

Medical Director of Neuroradiology

San Fernando Valley Interventional Radiology & Imaging (SFI), RadNet

Tags

Vascular

Syndromes

PET

Non-infectious Inflammatory

Neuroradiology

Neuro

MRI

Idiopathic

CT

Brain

Acquired/Developmental

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