Yoshii Fumihito, Moriya Yusuke, Ohnuki Tomohide, Ryo Masafuchi, Takahashi Wakoh, Kohara Saori, Hashimoto Jun
Department of Neurology, Saiseikai Hiratsuka Hospital, 37-1 Tateno-cho, Hiratsuka, 254-0046, Japan; Department of Neurology, Tokai University Oiso Hospital, 21-1 Gakkyou, Oiso, Naka-gun, 259-0198, Japan.
Department of Neurology, Tokai University Oiso Hospital, 21-1 Gakkyou, Oiso, Naka-gun, 259-0198, Japan.
Clin Neurol Neurosurg. 2017 Sep;160:73-77. doi: 10.1016/j.clineuro.2017.06.017. Epub 2017 Jun 27.
Scans without evidence of dopaminergic deficits (SWEDDs) in dopamine transporter single-photon emission computed tomography (DAT-SPECT) are found in 3.6-19.6% of patients with clinically suspected Parkinson's disease (PD). We investigated whether combined use of I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy would be helpful to differentiate PD among SWEDDs patients.
145 patients with clinically suspected PD underwent both DAT-SPECT and MIBG myocardial scintigraphy. Striatal binding ratio (SBR) of DAT-SPECT and heart-to-mediastinal (H/M) ratio and washout rate (WR) of MIBG myocardial scintigraphy were calculated.
Among 18 SWEDDs patients (12.4%), 11 were finally diagnosed with PD based on follow-up for at least two years after the DAT-SPECT and MIGB myocardial scintigraphy scans. Among the latter group, 8 patients showed an H/M ratio of less than 2.2, and 9 showed WR above 30%.
Our results indicate that the combination of low H/M ratio and high WR of MIBG myocardial scintigraphy of SWEDDs patients may be helpful for detection of PD patients.
在临床疑似帕金森病（PD）患者中，多巴胺转运体单光子发射计算机断层扫描（DAT-SPECT）显示无多巴胺能缺陷证据的扫描结果（SWEDDs）占3.6%-19.6%。我们研究了联合使用1-间碘苄胍（MIBG）心肌闪烁显像是否有助于在SWEDDs患者中鉴别PD。
145例临床疑似PD患者接受了DAT-SPECT和MIBG心肌闪烁显像检查。计算DAT-SPECT的纹状体结合率（SBR）以及MIBG心肌闪烁显像的心脏与纵隔（H/M）比值和洗脱率（WR）。
在18例SWEDDs患者（12.4%）中，11例在DAT-SPECT和MIGB心肌闪烁显像扫描后至少随访两年，最终被诊断为PD。在后一组中，8例患者的H/M比值小于2.2，9例患者的WR高于30%。
我们的结果表明，SWEDDs患者MIBG心肌闪烁显像的低H/M比值和高WR相结合可能有助于检测出PD患者。
