Potential diagnostic value of regional myocardial adrenergic imaging using 123I-MIBG SPECT to identify patients with Lewy body diseases
Potential diagnostic value of regional myocardial adrenergic imaging using 123I-MIBG SPECT to identify patients with Lewy body diseases
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DOI：
10.1007/s00259-015-2989-6
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发表时间：
2015-06-01
影响因子：
9.1
通讯作者：
Agostini, Denis
中科院分区：
文献类型：
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作者：
Lebasnier, Adrien;Lamotte, Guillaume;Agostini, Denis
目的探讨局部心肌I-123-间碘苄胍（MIBG）单光子发射计算机断层扫描（SPECT）显像对Lewy小体病（LBD+）的诊断价值。包括帕金森病（PD）和路易体痴呆（DLB）。记忆障碍方面的神经科专家采用国际临床诊断标准确定最终临床诊断。在低能量高分辨率（LEHR）准直器上注射I-123-MIBG后4小时，使用17节段左心室模型（5点量表）获得平面[心脏与纵隔比率（HMR）]和I-123-MIBG SPECT[（神经支配缺陷评分（IDS）]。结果64例患者中，45例（70%）诊断为LBD+（DLB，n = 27; PD，n = 18），19例诊断为LBD-（5例其他痴呆，14例其他帕金森综合征）。LBD+与LBD-的HMR和IDS显著不同（1.30 +/- 0.21 vs 1.65 +/- 0.26，p < 0.001; 39 +/- 28 vs 8 +/- 16，p = 0.001）。鉴别LBD+（n = 45）和LBD-（n = 19）的最佳HMR和IDS截断值分别为1.47和6/68，其敏感性和特异性分别为82.2%和84.2%及86.7%和73.7%。
Purpose The aim of this study was to determine the potential diagnostic value of regional myocardial adrenergic I-123-metaiodobenzylguanidine (MIBG) single photon emission computed tomography (SPECT) imaging to identify patients with Lewy body diseases (LBD+).Methods Sixty-four consecutive patients who underwent cardiac I-123-MIBG SPECT to differentiate LBD+, including Parkinson's disease (PD) and dementia with Lewy bodies (DLB), from patients without LBD (LBD-) were retrospectively reviewed. A neurologist expert in memory disorders determined the final clinical diagnosis by using international clinical diagnostic criteria. Planar [heart to mediastinum ratio (HMR)] and I-123-MIBG SPECT[(innervation defect score (IDS)] using the 17-segment left ventricular model (five-point scale) were obtained 4 h after the injection of I-123-MIBG on a low-energy high-resolution (LEHR) collimator. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal HMR and IDS cut-off values to discriminate LBD+ from LBD-.Results Of the 64 patients, 45 (70 %) were diagnosed LBD+ (DLB, n = 27; PD, n = 18) and 19 were diagnosed LBD- (5 other dementias, 14 other parkinsonisms). The HMR and IDS of LBD+ were significantly different from those of LBD- (1.30 +/- 0.21 vs 1.65 +/- 0.26, p < 0.001; 39 +/- 28 vs 8 +/- 16, p = 0.001). The optimal HMR and IDS cut-off values to discriminate LBD+ (n = 45) from LBD- (n = 19) were 1.47 and 6/68, providing a sensitivity and specificity of 82.2 and 84.2 % and 86.7 and 73.7 %, respectively.Conclusion Regional myocardial adrenergic I-123-MIBG imaging SPECT has a potential diagnostic value to identify LBD+.