Combined use of dopamine transporter imaging (DAT-SPECT) and 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy for diagnosing Parkinson's disease
Combined use of dopamine transporter imaging (DAT-SPECT) and 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy for diagnosing Parkinson's disease
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DOI：
10.1016/j.jns.2017.01.042
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发表时间：
2017-04-15
影响因子：
4.4
通讯作者：
Hashimoto, Jun
中科院分区：
文献类型：
--
作者：
Yoshii, Fumihito;Ryo, Masafuchi;Hashimoto, Jun
背景资料：为探讨联合应用I-123-FP-CIT多巴胺转运体单光子发射计算机断层扫描（DAT-SPECT）和I-123-MIBG心肌灌注显像（MIBG）诊断帕金森病（PD）是否上级单独使用任一种方法。采用DAT-SPECT图像的特异性结合率（SBR）和MIBG图像的心脏与纵隔（H/M）比值作为定量测量。我们根据SBR值和H/M比值将患者分为4组，或根据DAT-SPECT的纹状体不对称指数（SAI）将患者分为两组，并检查各组的临床特征。我们还研究了SWEDDs（扫描没有证据的多巴胺能缺陷）患者的特征。结果：SBR值与早期和延迟H/M比值均呈显著相关。运动并发症和幻觉在SBR和H/M比值均较低的组中出现的频率较高，并且在SAL SWEDD较大的组中观察到8.3%的患者出现幻觉。DAT-SPECT的SBR诊断PD的敏感性和特异性分别为91.7%和15.0%，MIBG摄取的H/M比值诊断PD的敏感性和特异性分别为78.3%和90.0%，联合诊断PD的敏感性和特异性分别为74.2%和95.0%。DAT-SPECT与MIBG心肌显像联合应用可提高PD诊断的特异性，有助于了解临床特点或预测并发症。(C)2017爱思唯尔B. V.保留所有权利。
Background: To examine whether combined use of I-123-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) and I-123-MIBG myocardial scintigraphy (MIBG) is superior to either modality alone for diagnosing Parkinson's disease (PD).Methods: Patients with probable PD (n = 120) who underwent both DAT-SPECT and MIBG myocardial scintigraphy within short intervals were enrolled. Specific binding ratio (SBR) of DAT-SPECT images and heart-to-mediastinum (H/M) ratio of MIBG images were used as quantitative measures. We classified patients into 4 groups based on SBR value and H/M ratio, or into two groups based on the striatal asymmetry index (SAI) of DAT-SPECT, and examined the clinical features of each group. We also investigated the characteristics of SWEDDs (scans without evidence of dopaminergic deficits) patients. Finally, we calculated the sensitivity and specificity of each method and the combined method.Results: SBR value was significantly correlated with both early and delayed H/M ratio values. Motor complications and hallucinations were observed at high frequency in the group with both lower SBR and H/M ratio, and hallucinations appeared in the group with larger SAL SWEDDs were observed 8.3% of patients. The sensitivity and specificity of diagnosing PD were 91.7% and 15.0% by SBR of DAT-SPECT, 78.3% and 90.0% by H/M ratio of MIBG uptake, and 74.2% and 95.0% by the combined modalities, respectively.Conclusions: Combined use of DAT-SPECT and MIBG myocardial scintigraphy increases the specificity of PD diagnosis, and is helpful for understanding the clinical features or predicting complications. (C) 2017 Elsevier B.V. All rights reserved.