Juh Rahyeong, Pae Chi-Un, Lee Chang-Uk, Yang Dongwon, Chung Yongan, Suh Taesuk, Choe Boyoung
Department of Biomedical Engineering, St. Mary' Hospital, The Catholic University of Korea College of Medicine, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, South Korea.
Neurosci Res. 2005 Jul;52(3):211-9. doi: 10.1016/j.neures.2005.03.010. Epub 2005 Apr 26.
A differential diagnosis of idiopathic parkinsonian disease (IPD) and multiple system atrophy (MSA) is difficult due to their common signs and symptoms. The aim of this 18F-2-fluoro-2 deoxyglucose (18F-FDG) positron emission tomography (PET) study was to compare the regional cerebral glucose metabolism in MSA with that in IPD by statistical parametric mapping (SPM) and image registration.
The 18F-FDG PET images of MSA and IPD patients were assessed by SPM and image registration to determine metabolic patterns that may be useful in differentiating between the two groups. Eleven patients with MSA, eight patients with IPD and 22 healthy controls participated in the study.
The IPD patients were found to have a significant glucose hypometabolism in comparison with the healthy controls in the prefrontal, lateral frontal, and parietotemporal cortices, and the cingulate and caudate areas (p< or =0.01, 100 voxel-level). In patients with MSA, hypometabolism was observed in the putamen, pons, and cerebellum in comparison with the healthy controls and IPD patients.
The voxel-based analysis of 18F-FDG PET images showed detailed differences between IPD and MSA, which may be useful in differentiating the two disease entities, as evidenced by the correlation of glucose metabolism with disease severity and dopamine agonist medication. The mapping analysis of 18F-FDG PET images might be a useful adjunctive method of a differential diagnosis for parkinsonism in a clinical setting.
特发性帕金森病（IPD）和多系统萎缩（MSA）具有一些共同的体征和症状，因此两者的鉴别诊断存在困难。本项18F-2-氟-2-脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）研究旨在通过统计参数映射（SPM）和图像配准比较MSA与IPD的局部脑葡萄糖代谢情况。
采用SPM和图像配准技术对MSA和IPD患者的18F-FDG PET图像进行评估，以确定可能有助于区分这两组疾病的代谢模式。11例MSA患者、8例IPD患者和22名健康对照者参与了本研究。
与健康对照相比，IPD患者在前额叶、额叶外侧、顶颞叶皮质以及扣带回和尾状核区域存在明显的葡萄糖代谢减低（p≤0.01，100体素水平）。与健康对照和IPD患者相比，MSA患者的壳核、脑桥和小脑存在代谢减低。
基于体素的18F-FDG PET图像分析显示了IPD和MSA之间的详细差异，这可能有助于区分这两种疾病实体，葡萄糖代谢与疾病严重程度和多巴胺激动剂用药之间的相关性证明了这一点。18F-FDG PET图像的映射分析可能是临床环境中帕金森病鉴别诊断的一种有用辅助方法。
