Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease
Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease
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DOI：
10.1111/j.1468-1331.2008.02372.x
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发表时间：
2009-02-01
影响因子：
5.1
通讯作者：
Kawamura, T.
中科院分区：
文献类型：
--
作者：
Sawada, H.;Oeda, T.;Kawamura, T.
目的评估心脏（123）i -甲氧十二苄基胍（MIBG）闪烁图对帕金森病的诊断准确性。采用MIBG闪烁图指数测试和英国帕金森病脑库标准参考标准对403例患者进行横断面研究。在20 min （H/M早期）和4 H （H/M晚期）测定心脏-纵隔MIBG积累比。分析受试者-操作者特征（ROC）曲线下面积、检测帕金森病的敏感性和特异性。在病程为3年或更短的患者亚组中分析准确性。早期或晚期H/M作为诊断标志的ROC曲线下面积为0.89（早期H/M的95% CI为0.85-0.92，晚期H/M的95% CI为0.86-0.93）。早期H/M的敏感性和特异性分别为81.3%（76.1-85.8%）和85.0%(77.7-90.6%)，晚期H/M的敏感性和特异性分别为84.3%（79.3-88.4%）和89.5%（83.01-94.1%）。病程3年及以下亚组早期H/M的ROC曲线面积、敏感性和特异性分别为0.86（0.79 ~ 0.92）、76.0%（64.8 ~ 85.1%）和83.9%(71.7 ~ 92.4%)，晚期H/M的ROC曲线面积、敏感性和特异性分别为0.85（0.78 ~ 0.92）、73.3%（61.9 ~ 82.9%）和87.5%（75.9 ~ 94.8%）。虽然心脏MIBG闪烁图的诊断准确性较高，但由于对病程短的患者敏感性不足，其诊断准确性受到限制。
To estimate the diagnostic accuracy of cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease.A cross-sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson's Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac-to-mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver-operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less.Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85-0.92 for early H/M and 0.86-0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1-85.8%) and 85.0% (77.7-90.6%) for early H/M and 84.3% (79.3-88.4%) and 89.5% (83.01-94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79-0.92), 76.0% (64.8-85.1%), and 83.9% (71.7-92.4%) for early H/M and 0.85 (0.78-0.92), 73.3% (61.9-82.9%), and 87.5% (75.9-94.8%) for late H/M.Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.