Question 1361
{"accessible":false,"alternatives":[{"id":6786,"text":"Imaging features are characteristic of Alzheimer disease. "},{"id":6787,"text":"Non-diagnostic study. Repeat imaging in 12 months may be of benefit. "},{"id":6788,"text":"Normal study for age. No evidence of a neurodegenerative disease. "},{"id":6789,"text":"Subtle hippocampal volume loss, in this clinical setting, supports the clinical diagnosis of Alzheimer disease. "}],"archived":false,"correctAlternativeId":6789,"explanation":"\u003cp\u003eIt is important, particularly in the context of neurodegenerative diseases where few pathognomonic imaging biomarkers exist, to think in a Bayesian way; what are the pre-test probabilities of each possible diagnosis and does the scan move you towards or away from each of these.\u0026nbsp;\u003c/p\u003e\u003cp\u003eIn this setting, Alzheimer disease has a high pre-test probability. As the scan does not demonstrate a tumor or a subdural collection, nor does it have features strongly suggestive of an alternative diagnosis, even though the features are subtle the likelihood of this individual having Alzheimer disease are now higher than they were prior to the MRI.\u0026nbsp;\u003c/p\u003e","id":1361,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/1361","nextQuestionPath":"/articles/alzheimer-disease-1/questions/1358","relatedArticles":[{"id":28361,"title":"Neurodegenerative MRI brain (an approach)","link":"/articles/neurodegenerative-mri-brain-an-approach?lang=us"}],"alsoUsedIn":[{"id":492,"kind":"Course","title":"Neurodegenerative Learning Pathway - page 492","link":"https://radiopaedia.org/courses/neurodegenerative-learning-pathway/pages/492"},{"id":1052,"kind":"Course","title":"Neurodegenerative Learning Pathway - page 1052","link":"https://radiopaedia.org/courses/neurodegenerative-learning-pathway/pages/1052"},{"id":1052,"kind":"Course","title":"[TRIAL] Neurodegenerative Learning Pathway - page 1052","link":"https://radiopaedia.org/courses/trial-neurodegenerative-learning-pathway/pages/1052"},{"id":1172,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1172","link":"https://radiopaedia.org/courses/adult-neuroradiology-review-course/pages/1172"},{"id":1172,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1172","link":"https://radiopaedia.org/courses/adult-brain-mri-review-course-2015-online-video/pages/1172"}],"stem":"\u003cp\u003eAn 85-year-old man has been complaining of progressive difficulty with short term memory. No other specific neurological symptoms, signs or deficits are evident. An MRI is performed to assess for the possibility of Alzheimer disease. The scan is generally unremarkable with perhaps, at most, minor hippocampal volume loss.\u0026nbsp;\u003cbr\u003e\u003cbr\u003eWhich of the following would be the most useful conclusion for the MRI report?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1361"}],"attemptsPercentages":[{"alternativeId":"6787","percentage":15},{"alternativeId":"6786","percentage":1},{"alternativeId":"6788","percentage":12},{"alternativeId":"6789","percentage":72}],"promptToLogin":false,"questionManager":false,"articleId":"alzheimer-disease"}