| Objective1.The easy Z-score imaging system(eZIS)is used to analyze the SPECT images of brain perfusion SPECT and to explore its value in the diagnosis of early AD.2.To explore the diagnostic efficacy of single and joint analysis of three indexes of eZIS.Materials and methodsRetrospective analysis was performed on the clinical data of subjects who underwent brain perfusion SPECT examination in our department from September 2018 to January 2021,and cognitive scale assessment was performed.According to the 2011 version of NIA-AA criteria,13 patients with AD dementia(AD group),14 patients with mild cognitive impairment due to AD(MCI group)and 8 healthy elderly people without cognitive impairment(NC group)were diagnosed.All subjects had performed brain perfusion SPECT,and eZIS-assisted analysis was used to obtain the index values—severity,range and ratio.Statistical method was used to explore the value of eZIS-SPECT in the diagnosis of early AD and the diagnostic efficiency of single index value and combined analysis.Results1.There was no significant difference in sex,age and education level among the three groups(P>0.05);MMSE score was lower in the AD group and the MCI group than that in the NC group,MMSE score in the AD group was lower than that in the MCI group.The difference was statistically significant(H=27.28,P<0.05).2.The severity and range of AD group was higher than that of MCI group and NC group,and that of MCI group was higher than that of NC group.The diference was statistically significan(F=26.31,P<0.05;F=25.72,P<0.05).The ratio of AD group was higher than that of NC group and the difference was statistically significant(F=6.24,P<0.05).There was no significant difference between MCI group and NC group,AD group(P>0.05).3.In the early diagnosis of AD,the sensitivity of severity(71.4%)and diagnostic accuracy(77.3%)were the highest in single analysis.The sensitivity(85.7%)and diagnostic accuracy(86.4%)of the joint analysis of severity,range and ratio or the joint analysis of severity and ratio were the highest and higher than those of the single analysis.4.In the diagnosis of AD,the sensitivity of severity,range and diagnostic accuracy(both 100%)were the highest in single analysis.The sensitivity(100%)and diagnostic accuracy(95.2%)of all joint analyses were the highest.The specificity of joint analysis of each combination remained unchanged.5.In the early diagnosis of AD,the diagnostic performance(AUC=0.915)of severity was the highest.Except for the joint analysis of range and ratio,the diagnostic performance of other types of joint analysis was higher than that of single analysis,and the diagnostic performance of combined analysis of severity and range(AUC=0.915)was the highest.6.The correlation analysis between MMSE score and index value showed that there was a weak negative correlation between the range and MMSE score(P<0.05),but there was no correlation between severity,ratio and MMSE score(P>0.05).Conclusion1.eZIS-SPECT can provide numerical basis for early diagnosis of AD and has high clinical application value.2.In the early diagnosis of AD,the diagnostic value of joint analysis of three index values or severity and ratio showed better diagnostic efficacy;In the diagnosis of AD,the diagnostic value of single analysis of severity and range or joint analysis of different combinations is good,which can provide reference for clinical diagnosis.3.In order to further improve the diagnostic efficiency of eZIS-SPECT,each institution had better set and apply its own index cut-off value.4.The correlation between MMSE score and eZIS index value is weak,so it was recommended to combine with other cognitive assessment scales for early diagnosis of AD. |
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