帕金森病的单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）进展——第1部分：鉴别诊断成像
Update on SPECT and PET in parkinsonism - part 1: imaging for differential diagnosis.
作者信息
Meyer Philipp T, Hellwig Sabine
机构信息
aDepartment of Nuclear Medicine bDepartment of Neurology cDepartment of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany.
出版信息
Curr Opin Neurol. 2014 Aug;27(4):390-7. doi: 10.1097/WCO.0000000000000106.
PURPOSE OF REVIEW
To give an update on recent findings concerning the use of single-photon emission computed tomography (SPECT) and positron emission tomography (PET) for differential diagnosis and prognosis of neurodegenerative parkinsonism and related disorders.
RECENT FINDINGS
Several studies confirmed the very high diagnostic accuracy and clinical impact of imaging nigrostriatal function (most notably with [I]FP-CIT-SPECT) for diagnosing neurodegenerative parkinsonism and dementia with Lewy bodies. Accurate differential diagnosis of neurodegenerative parkinsonism can be achieved by imaging disease-specific patterns of cerebral glucose metabolism with [18F]fluorodeoxyglucose-PET, which surpasses the diagnostic accuracy of other currently available radionuclide imaging techniques.
SUMMARY
SPECT and PET are established methods for the differential diagnosis of parkinsonism with significant therapeutic and prognostic impact. Given the limited accuracy of the clinical diagnosis as the reference standard, future studies with post-mortem verification are needed for validation of diagnostic imaging pattern, particularly in tauopathies.
综述目的
介绍单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）在神经退行性帕金森病及相关疾病鉴别诊断和预后方面的最新研究成果。
最新研究成果
多项研究证实，对黑质纹状体功能进行成像（最显著的是使用[I]FP-CIT-SPECT）在诊断神经退行性帕金森病和路易体痴呆方面具有极高的诊断准确性和临床意义。通过使用[18F]氟脱氧葡萄糖PET对脑葡萄糖代谢的疾病特异性模式进行成像，可以实现神经退行性帕金森病的准确鉴别诊断，其诊断准确性超过了目前其他可用的放射性核素成像技术。
总结
SPECT和PET是用于帕金森病鉴别诊断的成熟方法，具有显著的治疗和预后意义。鉴于作为参考标准的临床诊断准确性有限，未来需要进行尸检验证的研究来验证诊断成像模式，特别是在tau蛋白病方面。
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