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三级医院的转诊实践、报告标准以及多巴胺转运体扫描的影响。

Referral practice, reporting standards, and the impact of dopamine transporter scans done in a tertiary hospital.

作者信息

Bhattacharjee Shakya, Chalissery Albi J, Barry Tim, O'Sullivan Donagh, O'Connell Martin, Lynch Timothy

机构信息

Department of Neurology, Plymouth Hospital NHS Trust, Devon, United Kingdom.

Department of Neurology, Mater Misercordiae University Hospital, Dublin, Ireland.

出版信息

Neurol India. 2017 Nov-Dec;65(6):1264-1270. doi: 10.4103/0028-3886.217946.

Abstract

AIMS

We studied the referral practice, reporting standards, and the impact of 123 ioflupane single photon emission computed tomogram dopamine transporters (DAT-SPECT) scans conducted for the diagnosis and clinical management of patients.

SETTINGS AND DESIGNS

The present study was a retrospective, non-interventional study.

MATERIALS AND METHODS

We assessed the DAT scan referral and the official reports available from the Nuclear Medicine Department of the Mater Misericordiae University Hospital over 1 year (2013). We also assessed the impact of the DAT scan result on the management of patients by analyzing patient records. The European Association of Nuclear Medicine Neuroimaging (EANM) 2010 and the Federal Drug Administration (FDA) 2012 guidelines were taken as the standard against which the quality of our DAT scans reporting was assessed.

STATISTICAL METHODS

Microsoft Excel 2010 and graphpad software were used for statistical analysis.

RESULTS

Twenty five (56.2%) out of a total of 48 DAT scans were performed to confirm early Parkinson's disease, 5 (8.9%) were done to exclude drug-induced parkinsonism, and 8 (14.3%) to distinguish essential tremor from parkinsonism; 2 scans were performed to distinguish Lewy body diseases from Alzheimer's dementia, and 4 indications were outside the recommended guidelines. Twelve out of the 26 (46%) abnormal scans had bilateral abnormalities. Twenty one out of the 25 DAT scans proved the clinical diagnosis of degenerative parkinsonism to be correct.

CONCLUSION

The overall compliance of the DAT imaging with the existing standard guidelines was good. DAT scan can be very useful in clinical practice because it influences the clinical diagnosis and management in 23% of the patients.

摘要

目的

我们研究了为患者的诊断和临床管理进行的123碘氟潘单光子发射计算机断层扫描多巴胺转运体(DAT-SPECT)扫描的转诊实践、报告标准及其影响。

设置与设计

本研究为回顾性非干预性研究。

材料与方法

我们评估了慈悲圣母大学医院核医学科1年(2013年)内的DAT扫描转诊情况和可得的官方报告。我们还通过分析患者记录评估了DAT扫描结果对患者管理的影响。以欧洲核医学协会神经影像学(EANM)2010年和美国食品药品监督管理局(FDA)2012年指南作为评估我们DAT扫描报告质量的标准。

统计方法

使用Microsoft Excel 2010和GraphPad软件进行统计分析。

结果

在总共48次DAT扫描中,25次(56.2%)用于确诊早期帕金森病,5次(8.9%)用于排除药物性帕金森综合征,8次(14.3%)用于区分特发性震颤与帕金森综合征;2次扫描用于区分路易体病与阿尔茨海默病痴呆,4次检查超出了推荐指南范围。26次异常扫描中有12次(46%)为双侧异常。25次DAT扫描中有21次证实退行性帕金森综合征的临床诊断正确。

结论

DAT成像总体上符合现有标准指南,情况良好。DAT扫描在临床实践中非常有用,因为它影响了23%患者的临床诊断和管理。

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