Matsusue Eiji, Fujihara Yoshio, Tanaka Kenichiro, Aozasa Yuki, Shimoda Manabu, Nakayasu Hiroyuki, Nakamura Kazuhiko, Ogawa Toshihide
1 Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan.
2 Department of Neurology, Tottori prefectural Central Hospital, Tottori, Japan.
Acta Radiol. 2019 Feb;60(2):230-238. doi: 10.1177/0284185118778871. Epub 2018 May 27.
Neuromelanin magnetic resonance imaging (NmMRI) and I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguishes Parkinson's disease (PD) from non-degenerative parkinsonian syndrome (NDPS).
To determine whether a multiparametric scoring system (MSS) could improve accuracy compared to each parameter of DAT-SPECT and NmMRI in differentiating PD from NDPS.
A total of 49 patients, including 14 with NDPS, 30 with PD, and five with atypical parkinsonian disorder (APD) underwent both NmMRI and DAT-SPECT and were evaluated. The average (Ave) and the asymmetry index (AI) were calculated in the substantia nigra compacta area (SNc-area), SNc midbrain-tegmentum contrast ratio (SNc-CR), and specific binding ratio (SBR). Cut-off values were determined, using receiver operating characteristic (ROC) analysis, for the differentiation of PD from NDPS on the statistically significant parameters. All cases were scored as either 1 (PD) or 0 (NDPS) for each parameter according to its threshold. These individual scores were totaled for each case, yielding a combined score for each case to obtain a cut-off value for the MSS.
The Ave-SNc-area, Ave-SNc-CR, and Ave-SBR in PD were significantly lower than those in NDPS. The AI-SNc-area and AI-SBR in PD were significantly higher than those in NDPS. Of the five parameters, the highest accuracy was 93% for the Ave-SNc-area. For the MSS, a cut-off value of 3 was the accuracy of 96%. Besides, no significant difference was observed between PD and APD on all parameters.
An MSS has comparable or better accuracy compared to each parameter of DAT-SPECT and NmMRI in distinguishing PD from NDPS.
神经黑色素磁共振成像（NmMRI）和碘氟苯腈多巴胺转运体单光子发射计算机断层扫描（DAT-SPECT）提供了可将帕金森病（PD）与非退行性帕金森综合征（NDPS）区分开来的特定信息。
确定与DAT-SPECT和NmMRI的各参数相比，多参数评分系统（MSS）在区分PD和NDPS时是否能提高准确性。
共49例患者接受了NmMRI和DAT-SPECT检查并进行评估，其中包括14例NDPS患者、30例PD患者和5例非典型帕金森病（APD）患者。计算黑质致密部区域（SNc区）的平均值（Ave）和不对称指数（AI）、SNc中脑-被盖对比度（SNc-CR）以及特异性结合率（SBR）。使用受试者操作特征（ROC）分析确定在具有统计学意义的参数上区分PD和NDPS的临界值。根据每个参数的阈值，所有病例的每个参数均评分为1（PD）或0（NDPS）。将每个病例的这些个体评分相加得出每个病例的综合评分，从而获得MSS的临界值。
PD患者的Ave-SNc区、Ave-SNc-CR和Ave-SBR显著低于NDPS患者。PD患者的AI-SNc区和AI-SBR显著高于NDPS患者。在这五个参数中，Ave-SNc区的最高准确率为93%。对于MSS，临界值为3时准确率为96%。此外，在所有参数上，PD和APD之间未观察到显著差异。
在区分PD和NDPS方面，与DAT-SPECT和NmMRI的各参数相比，MSS具有相当或更高的准确性。
