Kwon Kyum-Yil, Choi Choong G, Kim Jae S, Lee Myoung C, Chung Sun J
Center for Parkinsonism and Other Movement Disorders, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mov Disord. 2007 Dec;22(16):2352-8. doi: 10.1002/mds.21714.
To investigate the diagnostic value of brain magnetic resonance image (MRI) and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) in the differentiation of multiple system atrophy (MSA) from Parkinson's disease (PD). Thirty-five patients with MSA (23 MSA-P and 12 MSA-C) and 17 patients with PD were included in this study. Overall correct diagnosis rates between clinical and imaging diagnosis among MSA-P, MSA-C, and PD patients were 80% for visual MRI analysis, 88.5% for visual (18)F-FDG PET analysis, and 84.3% for SPM-supported analysis of (18)F-FDG PET. The sensitivity of brain MRI, and visual and SPM analysis of (18)F-FDG PET in differentiating MSA from PD was 72.7%, 90.9%, and 95.5%, respectively, the specificity was 100% for each imaging analysis, the positive predictive value was 100% for each imaging analysis, and the negative predictive value was 60%, 81.8%, and 90%, respectively. Our results suggest that brain MRI and (18)F-FDG PET are diagnostically useful in differentiating MSA (MSA-P and MSA-C) from PD, and indicate that (18)F-FDG PET has a tendency toward higher sensitivity compared to brain MRI, but a larger longitudinal study including pathological data will be required to confirm our findings.
探讨脑磁共振成像（MRI）和18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）在多系统萎缩（MSA）与帕金森病（PD）鉴别诊断中的价值。本研究纳入了35例MSA患者（23例MSA-P和12例MSA-C）和17例PD患者。在MSA-P、MSA-C和PD患者中，视觉MRI分析的临床与影像诊断总体正确诊断率为80%，视觉18F-FDG PET分析为88.5%，18F-FDG PET的统计参数映射（SPM）支持分析为84.3%。脑MRI以及18F-FDG PET的视觉和SPM分析在鉴别MSA与PD时的敏感性分别为72.7%、90.9%和95.5%，每种影像分析的特异性均为100%，阳性预测值均为100%，阴性预测值分别为60%、81.8%和90%。我们的结果表明，脑MRI和18F-FDG PET在鉴别MSA（MSA-P和MSA-C）与PD方面具有诊断价值，并表明18F-FDG PET与脑MRI相比有更高敏感性的趋势，但需要纳入病理数据的更大规模纵向研究来证实我们的发现。
