Sakamoto Fumi, Shiraishi Shinya, Tsuda Noriko, Ogasawara Koji, Yoshida Morikatsu, Yuki Hideaki, Hashimoto Mamoru, Tomiguchi Seiji, Ikeda Manabu, Yamashita Yasuyuki
1 Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
2 Department of Neuropsychiatry, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Br J Radiol. 2016 Aug;89(1064):20160144. doi: 10.1259/bjr.20160144. Epub 2016 May 25.
: We performed I-meta-iodobenzylguanidine (I-MIBG) myocardial scintigraphy for the diagnosis of Lewy body disease (LBD) and assessed whether the early heart-to-mediastinum (H/M) ratio was diagnostic and whether visual image analysis was useful.
: Our study included 453 patients with clinically suspected LBD who had undergone I-MIBG myocardial scintigraphy. We evaluated semi-quantitative values (early and delayed H/M ratio, washout rate) and performed visual image analysis. The sensitivity, specificity, accuracy, positive-predictive value (PPV) and negative-predictive value (NPV) of both analyses were calculated.
: The early H/M ratio exhibited the best diagnostic ability. Its overall sensitivity, specificity, accuracy, PPV and NPV were 72.2%, 93.1%, 84.3%, 88.5% and 82.2%, respectively (cut-off value 2.2 or less). However, there was no significant difference from the delayed H/M ratio or the results of visual assessment.
: I-MIBG myocardial scintigraphy accurately differentiates between patients with and without LBD and a correct diagnosis can be established based on the early H/M ratio. We also document that visual evaluation of scintigrams is useful. Therefore, patients may benefit from the single performance of the procedure because a correct diagnosis can be obtained early in the disease process and their prognosis and appropriate treatment can be determined.
: I-MIBG myocardial scintigraphy on the early H/M ratio makes it possible to differentiate between patients with LBD and patients without LBD.
我们进行了间碘苄胍（I-MIBG）心肌闪烁显像以诊断路易体病（LBD），并评估早期心/纵隔（H/M）比值是否具有诊断价值以及视觉图像分析是否有用。
我们的研究纳入了453例临床疑似LBD且接受了I-MIBG心肌闪烁显像的患者。我们评估了半定量值（早期和延迟H/M比值、洗脱率）并进行了视觉图像分析。计算了两种分析方法的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。
早期H/M比值显示出最佳诊断能力。其总体敏感性、特异性、准确性、PPV和NPV分别为72.2%、93.1%、84.3%、88.5%和82.2%（临界值为2.2或更低）。然而，与延迟H/M比值或视觉评估结果相比，差异无统计学意义。
I-MIBG心肌闪烁显像能准确区分LBD患者和非LBD患者，基于早期H/M比值可做出正确诊断。我们还证明了闪烁图的视觉评估是有用的。因此，患者可能从单次检查中获益，因为在疾病过程早期即可获得正确诊断，并可据此确定其预后和适当的治疗方案。
基于早期H/M比值的I-MIBG心肌闪烁显像能够区分LBD患者和非LBD患者。
