0:00

So when a patient presents with dementia, what imaging studies should be

0:04

ordered, CT or MRI? Well, we prefer MRI. It has a lot of

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advantages over CT, and primarily that there are a lot of additional diagnoses

0:13

that can be seen with MRI that you just cannot see with CT.

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So, for example, this patient actually had an FDG brain PET CT and

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a PET MRI on the exact same base. We've got both the CT

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and the MRI component. The surface maps of the PET look pretty typical

0:29

for Alzheimer's. We have hypometabolism in the temporal lobes and in the

0:33

parietal lobe. And if we had only just done the CT,

0:39

we would have never been able to tell that this patient has an

0:41

acute infarct here in the right frontal centrum semiovale. Also, if we had

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only just done the CT, we wouldn't have seen all these little foci of old

0:50

hemosiderin staining that tell us that this patient actually has cerebral

0:54

amyloid angiopathy. Additionally, if we had only had the CT, we probably

0:59

wouldn't have seen all this inflammation around those area of microhemorrhages.

1:03

So not only does this patient have CAA, but they have cerebral amyloid angiopathy

1:07

related inflammation. So you can see how useful the MRI is over CT.

1:13

Now, sometimes the patient has a contraindication to MR and you can't get

1:16

it, but if we can, we always encourage an MRI.