Differential Diagnosis of Parkinsonism Using Dual-Phase F-18 FP-CIT PET Imaging
Differential Diagnosis of Parkinsonism Using Dual-Phase F-18 FP-CIT PET Imaging
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DOI：
10.1007/s13139-012-0182-4
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发表时间：
2013-03-01
影响因子：
1.3
通讯作者：
Kim, Jae Seung
中科院分区：
文献类型：
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作者：
Jin, Soyoung;Oh, Minyoung;Kim, Jae Seung
目的多巴胺转运蛋白（DAT）显像可显示帕金森病（PD）突触前多巴胺能神经元的丢失。然而，区分非典型帕金森综合征（APD）和PD往往是困难的。方法98例正常人5例，药物性帕金森综合征（DIP）7例，原发性震颤（ET）5例，帕金森病（PD）24例，多系统萎缩-帕金森型（MSA-P）20例，多系统萎缩-小脑型（MSA-C）13例，13例进行性核上性麻痹（PSP）和11例路易体痴呆（DLB）接受F-18 FP-CIT PET。在给予F-18 FP-CIT（185 MBq）后5 min（早期）和3 h（晚期）采集PET图像。结果正常组、ET组、DIP组和MSA-C组纹状体DAT结合正常，PD组、MSA-P组、PSP组和DLB组纹状体DAT结合异常。除MSA-C组外，正常DAT结合组的早期图像区域摄取无差异。在SPM分析中，与PD相比，异常DAT结合组在早期图像上显示不同的区域摄取模式（FDR< 0.05）。当区分APD和PD时，早期图像的视觉解释显示出较高的诊断灵敏度和特异性（分别为75.4%和100%）。结论F18 FP-CIT PET双时相显像可用于显示神经退行性帕金森病患者纹状体DAT的丢失，并可用于鉴别APD，尤其是MSA与PD。
Purpose Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual-phase F-18 FP-CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism.Methods Ninety-eight subjects [five normal, seven druginduced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy-parkinson type (MSA-P), 13 multiple system atrophy-cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies (DLB)] underwent F-18 FP-CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F-18 FP-CIT administration (185 MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images and striatal DAT binding pattern was assessed on late phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses.Results Striatal DAT binding was normal in normal, ET, DIP, and MSA-C groups, but abnormal in PD, MSA-P, PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA-C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR< 0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4 % and 100 %, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81 % for MSA-P, 77 % for MSA-C, 23 % for PSP, and 54.5 % for DLB.Conclusions Dual-phase F-18 FP-CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD.