Dementia: The role of CT/MRI in clinical practice

This paper reviews that use of imaging techniques to aid in the clinical diagnosis of dementia. Using CT/MRI only for exclusion of treatable disease may yield very little, if any, information that was not identified clinically. Using MRI/CT as a diagnostic tool to identify changes specific for causes of dementia may be more productive. Any assessment of medial temporal lobe atrophy on MRI will result in a reasonably high positive likelihood ratio distinguishing AD patients from non-demented individuals but fails to distinguish AD patients from patients with other dementias. For a diagnosis of vascular dementia imaging is necessary, although not all vascular changes fulfil requirements of being relevant dementia. Potentially of more importance, given the higher prevalence of AD, is identifying concomitant vascular changes in AD that may be amenable to therapy and may be used to identify subgroups.