Kim Hae Won, Kim Jae Seung, Oh Minyoung, Oh Jungsu S, Lee Sang Joo, Oh Seung Jun, Chung Sun Ju, Lee Chong Sik
Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
Department of Nuclear Medicine, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea.
Eur J Nucl Med Mol Imaging. 2016 Mar;43(3):517-25. doi: 10.1007/s00259-015-3191-6. Epub 2015 Sep 19.
The aim of this study was to evaluate whether striatal dopamine transporter (DAT) loss as measured by (18)F-fluorinated-N-3-fluoropropyl-2-b-carboxymethoxy-3-b-(4-iodophenyl) nortropane ([(18)F]FP-CIT) PET differs according to the metabolic subtype of multiple system atrophy (MSA) as assessed by [(18)F]FDG PET.
This retrospective study included 50 patients with clinically diagnosed MSA who underwent [(18)F]FP-CIT and [(18)F]FDG brain PET scans. The PET images were analysed using 12 striatal subregional volume-of-interest templates (bilateral ventral striatum, anterior caudate, posterior caudate, anterior putamen, posterior putamen, and ventral putamen). The patients were classified into three metabolic subtypes according to the [(18)F]FDG PET findings: MSA-Pm (striatal hypometabolism only), MSA-mixedm (both striatal and cerebellar hypometabolism), and MSA-Cm (cerebellar hypometabolism only). The subregional glucose metabolic ratio (MRgluc), subregional DAT binding ratio (BRDAT), and intersubregional ratio (ISRDAT; defined as the BRDAT ratio of one striatal subregion to that of another striatal subregion) were compared according to metabolic subtype.
Of the 50 patients, 13 presented with MSA-Pm, 16 presented with MSA-mixedm, and 21 presented with MSA-Cm. The BRDAT of all striatal subregions in the MSA-Pm and MSA-mixedm groups were significantly lower than those in the MSA-Cm group. The posterior putamen/anterior putamen ISRDAT and anterior putamen/ventral striatum ISRDAT in the MSA-Pm and MSA-mixedm groups were significantly lower than those in the MSA-Cm group.
Patients with MSA-Pm and MSA-mixedm showed more severe DAT loss in the striatum than patients with MSA-Cm. Patients with MSA-Cm had more diffuse DAT loss than patients with MSA-Pm and MSA-mixedm.
本研究旨在评估通过（18）F - 氟代 - N - 3 - 氟丙基 - 2 - β - 羧甲氧基 - 3 - β - （4 - 碘苯基）去甲托烷（[(18)F]FP - CIT）PET测量的纹状体多巴胺转运体（DAT）损失是否因通过[(18)F]FDG PET评估的多系统萎缩（MSA）代谢亚型而异。
这项回顾性研究纳入了50例临床诊断为MSA的患者，他们接受了[(18)F]FP - CIT和[(18)F]FDG脑PET扫描。使用12个纹状体亚区域感兴趣体积模板（双侧腹侧纹状体、尾状核前部、尾状核后部、壳核前部、壳核后部和腹侧壳核）分析PET图像。根据[(18)F]FDG PET结果将患者分为三种代谢亚型：MSA - Pm（仅纹状体代谢减低）、MSA - mixedm（纹状体和小脑均代谢减低）和MSA - Cm（仅小脑代谢减低）。根据代谢亚型比较亚区域葡萄糖代谢率（MRgluc）、亚区域DAT结合率（BRDAT）和亚区域间比率（ISRDAT；定义为一个纹状体亚区域与另一个纹状体亚区域的BRDAT比率）。
50例患者中，13例为MSA - Pm，16例为MSA - mixedm，21例为MSA - Cm。MSA - Pm组和MSA - mixedm组所有纹状体亚区域的BRDAT均显著低于MSA - Cm组。MSA - Pm组和MSA - mixedm组的壳核后部/壳核前部ISRDAT以及壳核前部/腹侧纹状体ISRDAT均显著低于MSA - Cm组。
MSA - Pm和MSA - mixedm患者纹状体中的DAT损失比MSA - Cm患者更严重。MSA - Cm患者的DAT损失比MSA - Pm和MSA - mixedm患者更弥漫。
