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1 30, 11-16, 2010 Z Z score Computed tomography ROC analysis 3 CT 1,2 CT 1/3 3 5 CT CT 6 7,8 MCA ASPECTS Alberta Stroke Programme Early CT Score 4 10 CT ASPECTS 50% 9 Z 10 CT Z CT 10 Z Z Z receiver operating characteristic : ROC Z CT 2 CT CT CT Emotion mm

12 1. ASPECTS 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 1 ASPECTS 10 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 21 2 ASPECTS 10 4 CT MRI CT 21 68 142 3 MRI CT

2 12 1. ASPECTS 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 1 ASPECTS C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M ASPECTS 10 4 CT MRI CT MRI CT CT Z ; 12 3 Z Z - 1 SPM2 Statistical Parametric Mapping 2 11, mm 2 1 CT Z CT CT CT CT Z Z Z CT Z MCA Z 5 CT Z 4 mm CT Z Z Z

3 CT CT ASPECTS 10 CT Z CT Z ASPECTS Z CT 50 Z Z ASPECTS AccuracyAccuracy Z Accuracy Student paired t - test Z ROC ROC ROC ROCKIT 0.9B C. E. Metz, University of Chicago, Ill 13 Z ROC areas under the ROC curves : AUC Jackknife 15 Jackknife LABM- RMC C.E. Metz, University of Chicago, Ill P Accuracy Z 81.2% 85.1% P=0.002 ROC 2 Z AUC P =0.03Z AUC Z

4 14 2. Z - ROC Z ASPECTS ASPECTS 10 AS- PECTS 9 ROC Z Z CT CT CT a CT L C M2 M3 M5 b Z - c MR CT CT CT 6

15 Accuracy Z 81.2% 85.1% ROC AUC Z 0.872 0.917 Z CT 4. 1.

5 15 Accuracy Z 81.2% 85.1% ROC AUC Z Z CT a CT L I b Z - c 2 CT Z 4 Z Adams H et al : Guidelines for the early management of patients with ischemic stroke : 2005 guidelines update a scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke 36 : , Adams JHP et al : Guidelines for the early management of patients with ischemic stroke : A scientific statement from the Stroke Council of the American Stroke Association. Stroke 34 : , von Kummer R et al : Acute stroke : usefulness of early CT findings before thrombolytic therapy. Radiology 205 : , Balbel PA et al : Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet 355 : , Kalafut MA et al : Detection of early CT signs of >1/3 middle cerebral artery infarctions : interrater reliability and sensitivity of CT interpretation by physicians involved in acute stroke care. Stroke 31 : , Fiebach JB et al : CT and diffusion - weighted MR imaging in randomized order : diffusion - weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 33 : , Schriger DL et al : Cranial computed tomography interpretation in acute stroke : physician accuracy in determining eligibility for thrombolytic therapy. JAMA 279 : , 1998

6 16 8Wardlaw JM et al : Early signs of brain infarction at CT : observer reliability and outcome after Thrombolytic treatment - systematic review. Radiology 235 : , Camargo ECS et al : Acute brain infarct : detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology 244 : , Takahashi N et al : Z - score mapping method for extracting hypoattenuation areas of hyperacute stroke in unenhanced CT. Acad Radiol 17 : 84-92, Friston KJ et al : Spatial registration and normalization of images. Hum Brain Mapp 3 : , Ashburner J et al : Nonlinear spatial normalization using basis functions. Hum Brain Mapp 7 : , Metz CE et al : Maximum likelihood estimation of receiver operating characteristic ROC curves from continuously - distributed data. Stat Med 17 : , Uozumi T et al : ROC analysis on detection of metastatic pulmonary nodules on digital chest radiographs by use of temporal subtraction. Acad Radiol 8 : , Dorfman DD et al : Receiver operating characteristic rating analysis. Generalization to the population of readers and patients with the jackknife method. Invest Radiol 27 : , 1992

H28_大和証券_研究業績_C本文_p indd

H28_大和証券_研究業績_C本文_p indd CT 画像診断におけるアルツハイマー病による内側側頭葉の萎縮度自動評価法の開発秋田県立脳血管研究センター放射線医学研究部特任研究員高橋規之 ( 共同研究者 ) 秋田県立脳血管研究センター放射線医学研究部部長木下俊文はじめに高齢化に伴い 10 年後には国内で 380 万人が認知症になると予測されておりその半数以上はアルツハイマー病である現在高度専門病院では positron emission