Is MRI better than CT for detecting a vascular component to dementia? A systematic review and meta-analysis

Rebecca Beynon, Jonathan A C Sterne, Gordon Wilcock, Marcus Likeman, Roger M. Harbord, Margaret Astin, Margaret Burke, Alysson Bessell, Yoav Ben-Shlomo, James Hawkins, William Hollingworth, Penny Whiting*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

21 Citations (Scopus)

Abstract

BACKGROUND: Identification of causes of dementia soon after symptom onset is important, because appropriate treatment of some causes of dementia can slow or halt its progression or enable symptomatic treatment where appropriate. The accuracy of MRI and CT, and whether MRI is superior to CT, in detecting a vascular component to dementia in autopsy confirmed and clinical cohorts of patients with VaD, combined AD and VaD ("mixed dementia"), and AD remain unclear. We conducted a systematic review and meta-analysis to investigate this question., METHODS: We searched eight databases and screened reference lists to identify studies addressing the review question. We assessed study quality using QUADAS. We estimated summary diagnostic accuracy according to imaging finding, and ratios of diagnostic odds ratios (RDORs) for MRI versus CT and high versus low risk of bias., RESULTS: We included 7 autopsy and 31 non-autopsy studies. There was little evidence that selective patient enrolment and risk of incorporation bias impacted on diagnostic accuracy (p[THIN SPACE]=[THIN SPACE]0.12 to 0.95). The most widely reported imaging finding was white matter hyperintensities. For CT (11 studies) summary sensitivity and specificity were 71% (95% CI 53%-85%) and 55% (44%-66%). Corresponding figures for MRI (6 studies) were 95% (87%-98%) and 26% (12%-50%). General infarcts was the most specific imaging finding on MRI (96%; 95% CI 94%-97%) and CT (96%; 93%-98%). However, sensitivity was low for both MRI (53%; 36%-70%) and CT (52%; 22% to 80%). No imaging finding had consistently high sensitivity. Based on non-autopsy studies, MRI was more accurate than CT for six of seven imaging findings, but confidence intervals were wide., CONCLUSION: There is insufficient evidence to suggest that MRI is superior to CT with respect to identifying cerebrovascular changes in autopsy-confirmed and clinical cohorts of VaD, AD, and 'mixed dementia'.
Original languageEnglish
Article number33
Number of pages10
JournalBMC Neurology
Volume12
DOIs
Publication statusPublished - 6 Jun 2012

Bibliographical note

M1 - 100968555

Keywords

  • CT
  • Dementia
  • Diagnosis
  • MRI
  • Systematic review

Fingerprint

Dive into the research topics of 'Is MRI better than CT for detecting a vascular component to dementia? A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this