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Neuroradiology
Published in: Neuroradiology 4/2019

Open Access 01-04-2019 | Computed Tomography | Diagnostic Neuroradiology

Structural imaging findings on non-enhanced computed tomography are severely underreported in the primary care diagnostic work-up of subjective cognitive decline

Authors: Claes Håkansson, Gustav Torisson, Elisabet Londos, Oskar Hansson, Danielle van Westen

Published in: Neuroradiology | Issue 4/2019

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Abstract

Purpose

The purpose of this study was to investigate how structural imaging findings of medial temporal lobe atrophy (MTA), posterior cortical atrophy (PCA), global cortical atrophy (GCA), white matter changes (WMC), and Evans’ index/width of lateral ventricles (EI/WLV) are reported in the primary care diagnostic work-up of patients with subjective cognitive decline or mild cognitive impairment.

Methods

We included 197 patients referred to a non-enhanced computed tomography (NECT) as part of the diagnostic work-up. We compared the frequencies of reported findings in radiology reports written by neuroradiologists and general radiologists with actual pathological findings in a second view done by a single neuroradiologist using the MTA, PCA, GCA, WMC, and EI/WLV visual rating scales. Structural findings were also compared to cognitive tests.

Results

We found that MTA and PCA were clearly underreported by both neuroradiologists and general radiologists. The presence of GCA and WMC was also underreported among general radiologists. Only MTA showed a clear association with cognitive test results.

Conclusions

We believe that the use of visual rating scales should be put into clinical practice to increase the yield of clinical NECT exams in the investigation of cognitive impairment. Special emphasis should be put on reporting MTA.
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Metadata
Title
Structural imaging findings on non-enhanced computed tomography are severely underreported in the primary care diagnostic work-up of subjective cognitive decline
Authors
Claes Håkansson
Gustav Torisson
Elisabet Londos
Oskar Hansson
Danielle van Westen
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 4/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-019-02156-6

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