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[123I-间碘苄胍心肌交感神经支配闪烁显像与帕金森病。初步结果]

[123 I-MIBG myocardial sympathetic innervation scintigraphy and Parkinson's disease. Preliminary results].

作者信息

Jiménez-Hoyuela J M, Rebollo A C, Campos V, Rius F

机构信息

Servicios de Medicina Nuclear. Hospital Universitario Virgen de la Victoria. Málaga. Spain.

出版信息

Rev Esp Med Nucl. 2003 Jul-Aug;22(4):229-37. doi: 10.1016/s0212-6982(03)72191-0.

Abstract

OBJECTIVES

Cardiac sympathetic function in patients with Parkinson's disease (PD) is significantly impaired. Cardiac scintigraphy with 123I-metaiodobenzylguanidine (123I-MIBG) is used to assess cardiac sympathetic function.

METHODS

A total of 29 consecutive patients with PD and 10 control subjects without neurological disease were studied. Myocardial imaging with 123I-MIBG was performed to evaluate cardiac sympathetic function. Early and delayed images of the anterior view were obtained at 15 min. and 4 h. after injection of 123I-MIBG, respectively. 123I-MIBG uptake was quantified qualitatively and semiquantitatively by calculating a heart-to-mediastinum (H/M) ratio.

RESULTS

The heart/mediastinum ratio was markedly reduced in patients with PD (I to IV on the Hoehn and Yahr scale) when compared to the control subjects (p < 0.05). This finding was independent of the length and severity of the disease or the pharmacological treatment of the patients. None of the control subjects showed decrease in myocardial 123I-MIBG uptake.

CONCLUSIONS

Our findings indicate that a decrease in myocardial accumulation of 123I-MIBG was observed in the early stages of PD. This suggests that the measurement of 123I-MIBG may help the early diagnosis of PD, and can be used to detect cardiac autonomic dysfunction, especially in patients without typical signs and symptoms.

摘要

目的

帕金森病(PD)患者的心脏交感神经功能显著受损。用123I-间碘苄胍(123I-MIBG)进行心脏闪烁扫描以评估心脏交感神经功能。

方法

共研究了29例连续的PD患者和10例无神经系统疾病的对照受试者。用123I-MIBG进行心肌显像以评估心脏交感神经功能。分别在注射123I-MIBG后15分钟和4小时获得前位的早期和延迟图像。通过计算心-纵隔(H/M)比值对123I-MIBG摄取进行定性和半定量分析。

结果

与对照受试者相比,PD患者(Hoehn和Yahr分级为I至IV级)的心/纵隔比值明显降低(p<0.05)。这一发现与疾病的病程和严重程度或患者的药物治疗无关。对照受试者均未显示心肌123I-MIBG摄取减少。

结论

我们的研究结果表明,在PD早期观察到心肌123I-MIBG摄取减少。这表明123I-MIBG测量可能有助于PD的早期诊断,并可用于检测心脏自主神经功能障碍,尤其是在没有典型症状和体征的患者中。

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