醫學影像處理運用在輔助阿茲海默氏症之診斷

台灣社會已是高齡化社會，依內政部社會司的統計，截至93年2月份為止，全台已有210萬的老年人□，佔人□總數的9.29%，根據統計老人失智症的盛行率約為2至4%，全國總計約有四萬二千至八萬四千名失智老人，其中約五至九成為阿茲海默氏症，也就是說國內約有二萬一千名至七萬五千名病患，並且每年國內新增失智症病患則約在一萬五千名左右，造成社會沉重的負擔須長期的醫療與照顧，引發我們利用醫學影像處理技術，來輔助阿茲海默氏症之診斷的研究動機。本實驗採類實驗設計，研究對象包括阿茲海默氏症病人與老年的健康志願者各5名，共計10名。所有的病人及志願者均接受詳細的神經心理評估及知能篩檢測驗(CASI)，利用GE廠牌1.5T Singa Horizon LX的核磁共振斷層掃描儀(MRI)作頭部三維立體T1加權磁振影像掃描，蒐集受測者頭部之組織影像，運用醫學影像處理技術作量測腦萎縮（海馬迴／大腦的容積比），最後透過SPSS10.0統計軟體分析找出經由知能篩檢測驗常模轉換判定為正常或不正常病患與腦萎縮的相關性。最後我們印證腦萎縮（海馬迴／大腦的容積比）確實與阿茲海默氏症有非常顯著關聯性，同時設計阿茲海默氏症之診斷系統，未來只要將三維立體T1加權磁振影像掃描的頭部影像資料，透過醫學影像處理方式取得海馬迴與大腦之容積，就可以診斷阿茲海默氏症。
Taiwan's population is aging. Alzheimer's disease (AD) was estimated to affect between 21,000 and 75,000 elderly people in Taiwan in 2004, and since that time the number of cases of dementia, including AD, has increased by 15,000 per year, making it and AD a serious public health problem. The cost of AD is large and includes the cost of long-term medical and home care as well as loss of life quality. This study is a report of an experiment with a computer program we designed to be used with magnetic resonance (MR) imaging to assist in the diagnosis of AD. This study uses MR imaging, a software program we designed, and the Cognitive Ability Screening Instrument (CASI version C-2.0, 1997) to study five elderly patients with AD and five healthy elderly volunteers. The three dimensional MR TI-weighted images of whole brain were obtained by a 1.5 T MR scanner (GE Singa Horizon LX). We created an index of the brain atrophy by comparing the volumetric ratio between hippocampus and cerebrum with CASI cutoff scores. We found the relationship between this index of brain atrophy and severity of AD to be significant. The AD diagnosis system we designed is written in 6.0 Visual Basic and is easy to operate. The only data needed to use this program are the volumes of hippocampus and cerebrum.