From the *UT Southwestern; †University of Michigan; ‡Mayo Clinic; §Boston Medical Center; ∥Johns Hopkins University; ¶LAC-USC Medical Center; **MD Anderson Cancer Center, Houston, TX; ††Loyola University Medical Center; and ‡‡Medical College of Georgia.
Clin Nucl Med. 2017 Nov;42(11):847-852. doi: 10.1097/RLU.0000000000001815.
This American College of Radiology and American College of Nuclear Medicine joint clinical practice parameter is for performance of dopamine transporter single photon emission computed tomography (SPECT) imaging, for patients with movement disorders. Parkinsonian syndrome (PS) consists of a group of neurodegenerative diseases including Parkinson disease (PD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB). Accurate diagnosis of PS is critical for clinical management. An important diagnostic dilemma is the differentiation of PS and non-neurodegenerative disorders, such as essential tremor (ET) or drug-induced tremor, due to the overlap of clinical symptoms. The management approach to these conditions is distinctly different. An abnormal iodine-123 ioflupane SPECT scan suggests a decreased amount of dopamine transporter in the striatum, that is, a diagnosis of nigrostriatal neurodegenerative PS, whereas a normal scan suggests ET or other nondegenerative parkinsonism (drug-induced, vascular, or psychogenic).
本美国放射学院和美国核医学会联合临床实践参数是用于执行多巴胺转运体单光子发射计算机断层扫描（SPECT）成像，适用于运动障碍患者。帕金森综合征（PS）包括一组神经退行性疾病，包括帕金森病（PD）、进行性核上性麻痹（PSP）、多系统萎缩（MSA）、皮质基底节变性（CBD）和路易体痴呆（DLB）。PS 的准确诊断对临床管理至关重要。一个重要的诊断难题是区分 PS 和非神经退行性疾病，如特发性震颤（ET）或药物引起的震颤，因为这些疾病的临床症状有重叠。这些疾病的治疗方法明显不同。碘-123 ioflupane SPECT 扫描异常提示纹状体中的多巴胺转运体数量减少，即诊断为黑质纹状体神经退行性 PS，而扫描正常提示 ET 或其他非退行性帕金森病（药物引起、血管性或心因性）。
