I-123 DaTscan SPECT 脑显像在帕金森综合征中的应用：纹状体-尾状核比值的效用。
I-123 DaTscan SPECT Brain Imaging in Parkinsonian Syndromes: Utility of the Putamen-to-Caudate Ratio.
机构信息
Department of Radiology, University of Washington, Seattle, WA.
Department of Diagnostic Radiology and Nuclear Medicine at Rush University Medical Center, Chicago, IL.
出版信息
J Neuroimaging. 2018 Nov;28(6):629-634. doi: 10.1111/jon.12530. Epub 2018 Jun 14.
BACKGROUND AND PURPOSE
Computer-based analysis of Dopamine transporter imaging (DaTscan) can aid in image interpretation. In this study, we examined the distribution of putamen-to-caudate ratios (PCRs) obtained by using a clinically available semiquantification method.
METHODS
Medical records of 32 patients (M:16) with a diagnosis of Parkinson's disease (PD) (n = 22) or Parkinson's plus syndromes (PPS) (n = 10) based on clinical follow-up, were retrospectively reviewed. Single photon emission tomography (SPECT) imaging was performed 4 hours after intravenous injection of 3-5 mCi [I-123]-ioflupane. Semiquantitative evaluation using DaTQUANT software was performed. Utility of PCR with a cutoff of .7 and .8 in the diagnosis of nigrostriatal degeneration was assessed. PD and PPS groups based on clinical assessment and caudate-to-background ratio (CBR) were assessed separately.
RESULTS
Minimum PCR for both hemispheres was .74 ± .09 (Mean ± SD, range: .58-.89), with 65.63% patients (21/32) having PCR > .7. Mean PCR in mild nigrostriatal degeneration was .77 ± .08 (range: .62-.89) and in advanced nigrostriatal degeneration was .73 ± .09 (range: .58-.89). Mean PCR in PD group was .73 ± .09 (range: .58-.89) and in PPS group was .75 ± .10 (range: .61-.88).
CONCLUSIONS
Although PCR can intrinsically be a useful indication of disease, this ratio obtained in our analysis by using one of the clinically available automatic semiquantitative methods has large variability and might not be a reliable numeric marker in interpretation of [I-123]ioflupane studies. This may be due to difficulty in separating caudate from putamen on SPECT images, as well as the nonuniform decreased Ioflupane uptake in both putamen and caudate.
背景与目的
基于计算机的多巴胺转运体成像（DaTscan）分析有助于图像解读。本研究检测了使用临床可用的半定量方法获得的壳核比率（PCR）的分布。
方法
回顾性分析了 32 例（男 16 例）患者的病历，这些患者根据临床随访被诊断为帕金森病（PD）（n=22）或帕金森综合征（PPS）（n=10）。静脉注射 3-5mCi [I-123]-ioflupane 后 4 小时进行单光子发射断层扫描（SPECT）成像。使用 DaTQUANT 软件进行半定量评估。评估了 PCR 截断值为 0.7 和 0.8 时对黑质纹状体变性的诊断效用。根据临床评估和尾状核背景比（CBR）对 PD 和 PPS 组进行了单独评估。
结果
双侧最小 PCR 为 0.74±0.09（Mean±SD，范围：0.58-0.89），65.63%的患者（21/32）PCR>0.7。轻度黑质纹状体变性的平均 PCR 为 0.77±0.08（范围：0.62-0.89），晚期黑质纹状体变性的平均 PCR 为 0.73±0.09（范围：0.58-0.89）。PD 组的平均 PCR 为 0.73±0.09（范围：0.58-0.89），PPS 组的平均 PCR 为 0.75±0.10（范围：0.61-0.88）。
结论
虽然 PCR 本身可以作为疾病的有用指标，但本研究通过使用临床可用的自动半定量方法之一获得的比值存在较大的变异性，因此在 [I-123]ioflupane 研究的解读中可能不是一个可靠的数值标记。这可能是由于在 SPECT 图像上难以分离尾状核和壳核，以及壳核和尾状核中 Ioflupane 摄取的非均匀减少所致。
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