Division of Radiology, Department of Pathophysiological Therapeutic Science.
AJNR Am J Neuroradiol. 2013 Nov-Dec;34(11):2113-8. doi: 10.3174/ajnr.A3567. Epub 2013 Jun 6.
Progressive changes in the substantia nigra pars compacta and locus ceruleus of patients with Parkinson disease and Alzheimer disease visualized by neuromelanin MRI and cardiac postganglionic sympathetic nerve function on (123)I-metaiodobenzylguanidine scintigraphy have not been fully evaluated. We compared the diagnostic value of these modalities among patients with early Parkinson disease, late Parkinson disease, and Alzheimer disease.
We compared contrast ratios of signal intensity in medial and lateral regions of the substantia nigra pars compacta and locus ceruleus with those of the tegmentum of the midbrain and the pons, respectively, by use of neuromelanin MRI in patients with early Parkinson disease (n = 13), late Parkinson disease (n = 31), Alzheimer disease (n = 6), and age-matched healthy control subjects (n = 20). We calculated heart-to-mediastinum ratios on (123)I-metaiodobenzylguanidine scintigrams after setting regions of interest on the left cardiac ventricle and upper mediastinum.
The signal intensity of the lateral substantia nigra pars compacta on neuromelanin MRI was significantly reduced in early and late Parkinson disease, and that of the medial substantia nigra pars compacta was gradually and stage-dependently reduced in Parkinson disease. The signal intensity of the locus ceruleus was obviously reduced in late Parkinson disease. Signal reduction was not significant in the substantia nigra pars compacta and locus ceruleus of patients with Alzheimer disease. The heart-to-mediastinum ratio on (123)I-metaiodobenzylguanidine scintigrams was stage-dependently reduced in Parkinson disease and normal in Alzheimer disease. The signal intensity ratios in substantia nigra pars compacta and locus ceruleus on neuromelanin MRI positively correlated with the heart-to-mediastinum ratio on (123)I-metaiodobenzylguanidine scintigrams.
Both neuromelanin MRI and (123)I-metaiodobenzylguanidine scintigraphy can help to evaluate disease progression in Parkinson disease and are useful for differentiating Parkinson disease from Alzheimer disease.
帕金森病和阿尔茨海默病患者黑质致密部和蓝斑的神经黑色素 MRI 及（123）I-间碘苄胍闪烁显像的心脏节后交感神经功能的进行性变化尚未得到充分评估。我们比较了这些方法在早期帕金森病、晚期帕金森病和阿尔茨海默病患者中的诊断价值。
我们比较了早期帕金森病（n=13）、晚期帕金森病（n=31）、阿尔茨海默病（n=6）和年龄匹配的健康对照组（n=20）的黑质致密部和蓝斑的内侧和外侧区域的信号强度与中脑被盖和脑桥的信号强度的对比率。我们在设定左心室和上纵隔的感兴趣区域后，计算（123）I-间碘苄胍闪烁显像的心脏与纵隔比值。
神经黑色素 MRI 显示，早期和晚期帕金森病患者的外侧黑质致密部信号强度明显降低，帕金森病患者的内侧黑质致密部信号强度逐渐、阶段依赖性降低。蓝斑的信号强度明显降低。阿尔茨海默病患者的黑质致密部和蓝斑信号强度无明显降低。帕金森病患者的（123）I-间碘苄胍闪烁显像的心脏与纵隔比值呈阶段依赖性降低，而阿尔茨海默病患者则正常。神经黑色素 MRI 上的黑质致密部和蓝斑的信号强度比值与（123）I-间碘苄胍闪烁显像的心脏与纵隔比值呈正相关。
神经黑色素 MRI 和（123）I-间碘苄胍闪烁显像都有助于评估帕金森病的疾病进展，有助于将帕金森病与阿尔茨海默病相鉴别。
