The utility of cerebral perfusion SPECT analysis using SPM8, eZIS and vbSEE for the diagnosis of multiple system atrophy-parkinsonism
The utility of cerebral perfusion SPECT analysis using SPM8, eZIS and vbSEE for the diagnosis of multiple system atrophy-parkinsonism
复制标题
使用 SPM8、eZIS 和 vbSEE 进行脑灌注 SPECT 分析在多系统萎缩-帕金森病诊断中的应用
DOI：
10.1007/s12149-014-0928-4
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发表时间：
2015
影响因子：
2.6
通讯作者：
Keita Sakurai
中科院分区：
文献类型：
--
作者：
kiyonaga M;Takaji R;Matsumoto S;Yamada Y;Mori H;Hijiya N;Aramaki M.;Keita Sakurai
目的虽然正确的诊断对适当的治疗很重要，但由于早期症状相似，准确区分多系统萎缩伴显性帕金森病（MSA-P）和帕金森病（PD）往往很困难。本研究旨在探讨脑灌注单光子发射计算机断层扫描（SPECT）和基于体素的分析对MSA-P患者的诊断价值。方法38例早期MSA-P患者9例，PD患者11例，对照组18例。使用统计参数映射（SPM） 8和简易z评分成像系统（eZIS）程序计算患者和对照组之间提示灌注不足的z评分。使用基于体素的立体定向提取估计（vbSEE）程序来确定壳核、脑桥和小脑的目标感兴趣体积（voi），并将z分数量化为“程度”（这些voi中z分数为bbb2.0的体素的比率）和“严重程度”（这些voi中的平均z分数）。这些参数被用作受试者工作特征（ROC）分析的决定因素。结果MSA-P患者的小脑损伤程度和严重程度均高于PD患者。在ROC分析中，小脑VOI的程度和严重程度在曲线下的面积最高，分别为0.86和0.84，准确率分别为90%和90%。结论小脑明显灌注不足对MSA-P与PD的鉴别诊断价值最高。这种基于体素的脑灌注SPECT分析使用SPM8， eZIS，和vbSEE程序是有用的临床诊断MSA-P。
ObjectiveAlthough a correct diagnosis is important for appropriate management, accurately differentiating between multiple system atrophy with predominant parkinsonism (MSA-P) and Parkinson’s disease (PD) is often difficult because of similarities in the early-stage symptoms. The aim of this study was to evaluate the diagnostic value of cerebral perfusion single photon emission computed tomography (SPECT) and voxel-based analysis for diagnosing MSA-P patients.MethodsThirty-eight subjects (9 with early-stage MSA-P, 11 with PD, and 18 controls) were included in this study. Z-scores suggestive of hypoperfusion were calculated between patients and controls using statistical parametric mapping (SPM) 8 and easy Z-score imaging system (eZIS) programs. A voxel-based stereotactic extraction estimation (vbSEE) program was performed to determine the target volumes of interest (VOIs) in the putamen, pons, and cerebellum, and quantify Z-scores as “extent” (the rate of voxels with a Z-score >2.0 in these VOIs) and “severity” (average Z-scores in these VOIs). These parameters were used as the determinant in receiver operating characteristic (ROC) analyses.ResultsThe extent and severity of the cerebellar VOIs were higher in MSA-P patients than in PD patients. In ROC analyses, the extent and severity of the cerebellar VOI exhibited the highest areas under the curves of 0.86 and 0.84, and accuracies of 90 and 90 %, respectively.ConclusionsThe diagnostic value of significant cerebellar hypoperfusion was the highest for differentiating MSA-P from PD. This voxel-based analysis of cerebral perfusion SPECT using the SPM8, eZIS, and vbSEE programs is useful for clinically diagnosing MSA-P.