Usefulness of rCBF analysis in diagnosing Parkinson's disease: supplemental role with MIBG myocardial scintigraphy
Autor: | Shigeki Nagamachi, Ryuichi Nishii, Shozo Tamura, Keiichi Kawai, Hideyuki Wakamatsu, Syuichi Yamashita, Shigemi Futami, Seigo Fujita, Shogo Kiyohara, Masamitsu Nakazato, Hideo Arita |
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Rok vydání: | 2007 |
Předmět: |
Lewy Body Disease
Male Parkinson's disease Perfusion scanning Scintigraphy Sensitivity and Specificity Diagnosis Differential Technetium Tc 99m Exametazime medicine Humans Radiology Nuclear Medicine and imaging Parkinson Disease Secondary Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Parkinsonism Heart Parkinson Disease General Medicine Middle Aged medicine.disease nervous system diseases 3-Iodobenzylguanidine Cross-Sectional Studies Cerebral blood flow Cerebrovascular Circulation Female Occipital Lobe Differential diagnosis Radiopharmaceuticals Nuclear medicine business Occipital lobe Perfusion |
Zdroj: | Annals of nuclear medicine. 22(7) |
ISSN: | 0914-7187 |
Popis: | (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for differentiating idiopathic Parkinson's disease (PD) from parkinsonism (PS) caused by other disorders. However, cardiac MIBG uptake is affected by various causes. Alternatively, hypoperfusion in the occipital lobe of PD is reported recently.The objective is to clarify the correlation between regional cerebral blood flow (rCBF) alteration and cardiac MIBG uptake in PD. In addition, we examined whether additional brain perfusion analysis improved the differential diagnostic ability for PD from PS when compared with MIBG scintigraphy alone.Forty-nine patients with PD (27 mild groups: Hoehn and Yahr stages I, II; 22 severe groups: Hoehn and Yahr stages III, IV) and 28 patients with PS participated. We compared absolute rCBF values between PD and PS. In addition, we determined correlation between MIBG parameters and each rCBF value. Finally, we compared the diagnostic ability for the differentiation of PD from PS between two diagnostic criteria, each MIBG index abnormality alone [heart-to-mediastinum ratio, H/M (E)1.9, H/E (D)1.7, washout rate40%] and each MIBG index abnormality or occipital lobe hypoperfusion (36 ml/100 g per min).Absolute rCBF value of occipital lobe was significantly lower in severe PD as compared with PS or mild PD. In the correlation analysis, rCBF of occipital lobe correlated positively with MIBG parameters (H/M). Regarding the diagnostic ability, sensitivity improved by accounting for occipital hypoperfusion as compared with MIBG indices alone. In contrast, neither specificity nor accuracy improved by adding occipital lobe analysis.MIBG parameters (H/M) correlated positively with occipital hypoperfusion in PD. In the differential diagnosis between PD and PS, although its usefulness might be limited, analysis of rCBF in the occipital lobe added to (123)I-MIBG myocardial imaging can be recommended. |
Databáze: | OpenAIRE |
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