Utility of Oblique Coronal Images in Elderly and Cognitively Impaired Patients

Dear Editor, The ongoing and rapid increase in the number of elderly people in Korea has led to an increasing number of cognitive problems among this population.1 A nationwide survey has estimated the prevalence rates of mild cognitive impairment (MCI) and dementia among Koreans aged at least 65 years to be 24.1% and 8.1%, respectively.2 The number of dementia patients is expected to double every 20 years until 2050.2 Alzheimer’s disease (AD) is the most common cause of MCI and dementia.1,2 Since medial temporal atrophy (MTA) occurs early and prominently in patients with AD,3 a 5-point scoring system has been developed to rate the severity of the condition, from grade 0 (no MTA) to grade 4 (severe MTA).4 This scoring system is applied to oblique coronal T1weighted images that are obtained parallel to the brainstem axis (Fig. 1).4 It is known that the medial temporal anatomy is visualized better in coronal images than in axial images.5 Visual rating of MTA based on coronal images has been used as a reliable marker for AD since its introduction more than 20 years ago.6 Although a visual rating system for MTA using T1-weighted axial images was developed recently,7 it has not been used in other studies. Young Ho Park Jae-Won Jang So Young Park Min Jeong Wang Jae Hyoung Kim SangYun Kim