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Working with your Doctor - Getting a CT or MRI - DementiaGuide.com
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Getting a CT or MRI

A Computerized Telegraphic (CT) scan of the head is often included in the clinical assessment of patients with dementia. The purpose of the CT scan is not as much to look for signs of Alzheimer's disease , as it is to rule out other illnesses that might look like dementia. For example, certain types of stroke and brain tumors could be detected by a CT scan, and could be mistaken for Alzheimer's disease. At the same time, however, there is a strong opinion among physicians in Canada that a CT scan is not a necessary part of a work up of a patient with dementia. Unless there are signs of stroke or tumor on the neurological examination, if the patient has recently fallen, if the patient has a tendency to bleed, or the illness is progressing very quickly, it is argued that a CT scan is highly unlikely to make any difference in diagnosis . Some people would feel strongly that it is important to get a CT scan "to be on the safe side." However, the argument against CT scans is that it is costly, that it is another obstacle to getting on with treatment, and that the CT scan more commonly turns up small benign tumors. Small benign tumors pose unnecessary work and worry. Having surgery to remove these benign tumors can sometimes result in more harm than good in a patient with dementia.

A Magnetic Resident Imaging (MRI ) scan is similar to a CT scan but it gives more detail. At many leading centers, physicians rely on MRI to confirm a diagnostic opinion. While a single MRI cannot make a diagnosis of Alzheimer's disease, progressive atrophy presents the shrinkage of certain parts of the brain is very consistent with Alzheimer's disease. The argument against MRI tests is much the same for a CT scan, particularly in Canada where MRIs are much harder to obtain. The other argument is that by the time the MRI shows progressive shrinkage the diagnosis of Alzheimer's disease will be evident to an experienced observer.

The continuing debate about CT and MRI reflect a central fact about Alzheimer's disease, which is that the diagnosis remains a clinical one. What this means is that there is no specific X-ray or blood test that can definitely give the diagnosis. In consequence, a lot of the debate reflects how people feel about handlinguncertainty.

See Also:
About Dementia > Working with your Doctor > Getting a Diagnosis
About Dementia > Alzheimer's Disease > Diagnosis
About Dementia > Types of Dementia > Stroke
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Last updated January 13, 2019
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