Covelli Eugenio Maria, Brunetti Arturo, Di Lauro Andrea, Sullo Pasquale, Mazzarella Giancarlo, Tedeschi Enrico, Belfiore Giuseppe
Dipartimento di Diagnostica per Immagini, AORN San Sebastiano, Caserta, Italy.
Radiol Med. 2004 Oct;108(4):417-25.
Here we report our experience in a general hospital setting using [(123)I]-FP-CIT SPECT to diagnose patients with suspect Parkinson's disease (PD).
Thirty consecutive patients (19M, 11W, mean age: 61+/-13 years) were prospectively studied. Patients underwent MRI (27) at 1.5T or CT (3) when MRI was contraindicated, to rule out focal brain abnormalities. Motor and cognitive function were evaluated by neurologists with UPDRS and Hoehn e Yahr Scale. [(123)I]-FP-CIT striatal uptake, assessed with SPECT, was classified as normal, non-diagnostic, abnormal (unilateral or bilateral). Imaging results (SPECT+MRI) were correlated with the neurological findings.
In 5 patients the [(123)I]-FP-CIT brain SPECT was normal, suggesting that their symptoms could be related to a benign disorder such as essential tremor. Two patients had non-diagnostic [(123)I]-FP-CIT brain SPECT, with MRI/CT findings compatible with subcortical cerebrovascular disease. In the remaining 23 patients abnormal striatal [(123)I]-FP-CIT uptake correlated with neurological findings, significantly increasing the probability of Parkinson's disease. In these patients MRI/CT scans were normal, or showed a mild BA, or mild cerebral vascular disease (mild CVD).
Our results suggest that [(123)I]-FP-CIT scan could be used routinely in clinical practice to support the diagnosis of PD and to differentiate between other conditions. Moreover, FP-CIT could significantly impact treatment selection and follow-up of these patients.
本文报告我们在综合医院使用[（123）I]-FP-CIT单光子发射计算机断层扫描（SPECT）诊断疑似帕金森病（PD）患者的经验。
对连续30例患者（19例男性，11例女性，平均年龄：61±13岁）进行前瞻性研究。当MRI禁忌时，患者接受1.5T的MRI检查（27例）或CT检查（3例），以排除局灶性脑异常。神经科医生使用统一帕金森病评定量表（UPDRS）和霍恩-亚尔分级量表对运动和认知功能进行评估。通过SPECT评估的[（123）I]-FP-CIT纹状体摄取被分类为正常、非诊断性、异常（单侧或双侧）。影像学结果（SPECT+MRI）与神经学检查结果相关。
5例患者的[（123）I]-FP-CIT脑SPECT正常，提示其症状可能与诸如特发性震颤等良性疾病有关。2例患者的[（123）I]-FP-CIT脑SPECT为非诊断性，MRI/CT结果与皮质下脑血管疾病相符。在其余23例患者中，纹状体[（123）I]-FP-CIT摄取异常与神经学检查结果相关，显著增加了患帕金森病的可能性。在这些患者中，MRI/CT扫描正常，或显示轻度脑萎缩（BA），或轻度脑血管疾病（轻度CVD）。
我们的结果表明，[（123）I]-FP-CIT扫描可在临床实践中常规用于支持PD的诊断并区分其他疾病。此外，FP-CIT可能会对这些患者的治疗选择和随访产生重大影响。
