Dergi Ara >>
Yıl:2002; Cilt: 2; Sayı: 1>> Özet
Demans Dergisi; 2002;2(1):11-16
Demansın Değerlendirilmesinde Nükleer Tıp Yöntemleri
N Gökçora, Ö Akdemir
Gazi Üniversitesi Tıp Fakültesi Nükleer Tıp ABD, Ankara
Demans hastalarının değerlendirilmesinde,
hastalığın nedenini belirleyebilmek ve bu değerlendirmede
tanısal doğruluğu arttırabilmek için,
klinik değerlendirmeye ek olarak sıklıkla yapısal ve
işlevsel görüntüleme çalışmalarına başvurulmaktadır.
Birçok durumda verilebilecek tedavinin
başarısı, doğru tanının hastalığın erken döneminde
koyulabilmesine bağlıdır. Ayrıca klinik değerlendirme
ile tanı koymanın zor olduğu durumlarda
görüntüleme yöntemleri klinisyene yardımcı olabilirler.
Genel olarak amaç, demans hastalarında
tanıyı erken dönemde ve güvenilir biçimde sağlamak,
tedavi planına yardımcı olmak ve tedavi
etkinliğini değerlendirmektir.
Alzheimer hastalığı demansın en sık gözlenen ve
en önemli nedenidir. Alzheimer hastalığının ileri
evrelerinde klinik olarak hastalığın tanısını koymak
güç değildir. Önemli olan hastalığın erken döneminde
tanının nasıl ve hangi yöntemlerle koyulacağıdır.
Henüz yüzde 100 tanısal doğruluk gösteren bir
metod mevcut değildir. Bir yöntem hastalardan
biyopsi almak olabilir, ancak böylesi bir girişim
klinisyenler tarafından tercih edilmeyecektir.
Klinisyenlere tanılarında yardımcı olabilecek diğer
tanısal araçlar, yapısal görüntüleme yöntemleri
olan BT (Bilgisayarlı Tomografi) ve MRG'dir
(Manyetik Rezonans Görüntüleme).
PET (Positron Emission Tomography) ve SPECT
(Single Photon Emission Computerized
Tomography), demansa neden olan hastalıkların
tanınmasında farklı bir yaklaşım olanağı sunarlar.
PET ve SPECT bulguları, özellikle nöropsikolojik
değerlendirme bulguları ile birlikte ele alındığında
yararlıdır. Bu tekniklerde görüntü sağlamak için
kullanılan radyofarmasötikler beyinde, bölgesel
kan akımının, metabolizmanın ve hücreler arası
moleküler iletişimin ölçülebilmesini sağlar. Nükleer
tıp yöntemleri aracılığıyla Alzheimer hastalığına
erken dönemde noninvaziv ve güvenilir bir
biçimde tanı koymak olanaklıdır

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