Nishimori Miki, Murata Yoriko, Iwasa Hitomi, Miyatake Kana, Tadokoro Michiko, Kohsaki Shino, Nogami Munenobu, Hamada Norihiko, Ninomiya Hitoshi, Osaki Yasushi, Furuya Hirokazu, Yamagami Takuji
Department of Radiology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
Department of Radiology, JINSEI-KAI Hosogi Hospital, Kochi-shi, Kochi 780-0926, Japan.
Biomed Rep. 2018 Jun;8(6):523-528. doi: 10.3892/br.2018.1086. Epub 2018 Apr 11.
The aim of the present study was to compare the efficacy of magnetic resonance imaging (MRI) and I-labeled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane single photon emission computed tomography (I-FP-CIT SPECT) for determining the clinical severity of patients with multiple system atrophy with Parkinsonism (MSA-P). MRI and I-FP-CIT SPECT images from 17 patients with MSA-P as diagnosed using the Unified MSA Rating Scale part IV (UMSARS IV) score were compared. Brain MRI scans were available for all 17 patients and I-FP-CIT SPECT images were available for 12 patients. Putaminal atrophy (PA), hyperintense putaminal rim (HPR), hyperintense pons (hot cross bun sign, HCB), atrophy of the cerebellar vermis and hemisphere (cerebellar atrophy, CA) and other abnormalities were evaluated in the MRI scans. Distribution of striatal uptake (SU) and the specific binding ratio (SBR) on each side of the bilateral striatum were evaluated using I-FP-CIT SPECT images. No significant associations were observed between HPR, HCB, CA and UMSARS IV score. However, the frequency of PA increased significantly with higher UMSARS IV score (P<0.05). No significant association was observed between UMSARS IV score and SBR. The results of the present study suggest that PA, which is known to be a diagnostic indicator for MSA-P, may be used to determine the clinical severity of MSA-P with greater efficacy than other MRI findings, including HPR, HCB and CA and I-FP-CIT SPECT results.
本研究的目的是比较磁共振成像（MRI）和碘标记的2β-甲氧羰基-3β-（4-碘苯基）-N-（3-氟丙基）去甲托烷单光子发射计算机断层扫描（I-FP-CIT SPECT）在确定帕金森综合征型多系统萎缩（MSA-P）患者临床严重程度方面的疗效。比较了17例经统一MSA评定量表第四部分（UMSARS IV）评分诊断为MSA-P的患者的MRI和I-FP-CIT SPECT图像。17例患者均有脑部MRI扫描图像，12例患者有I-FP-CIT SPECT图像。在MRI扫描中评估壳核萎缩（PA）、壳核边缘高信号（HPR）、脑桥高信号（热交叉面包征，HCB）、小脑蚓部和半球萎缩（小脑萎缩，CA）及其他异常情况。使用I-FP-CIT SPECT图像评估双侧纹状体每侧的纹状体摄取分布（SU）和特异性结合率（SBR）。未观察到HPR、HCB、CA与UMSARS IV评分之间存在显著相关性。然而，PA的发生率随UMSARS IV评分升高而显著增加（P<0.05）。未观察到UMSARS IV评分与SBR之间存在显著相关性。本研究结果表明，已知为MSA-P诊断指标的PA，可能比包括HPR、HCB、CA和I-FP-CIT SPECT结果在内的其他MRI表现更有效地用于确定MSA-P的临床严重程度。
