[11C]DTBZ正电子发射断层扫描在临床诊断不明确的帕金森综合征中的诊断价值：单一三级中心的经验

Diagnostic Utility of [11C]DTBZ Positron Emission Tomography In Clinically Uncertain Parkinsonism: Experience of a Single Tertiary Center.

作者信息

Pérez-Lohman Christian, Kerik Nora E, Díaz-Meneses Ivan E, Cervantes-Arriaga Amin, Rodríguez-Violante Mayela

机构信息

Movement Disorders Clinic. Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.

Molecular Imaging PET-CT Unit. Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.

出版信息

Rev Invest Clin. 2018;70(6):285-290. doi: 10.24875/RIC.18002644.

DOI:10.24875/RIC.18002644

PMID:30532098

Abstract

BACKGROUND

The use of single-photon emission computed tomography and positron emission tomography (PET) has proven to be helpful in differentiating Parkinson's disease (PD) from other movement disorders with a sensitivity of up to 95%.

OBJECTIVE

The objective of this study was to determine the accuracy of [11C]DTBZ PET imaging in patients with clinically uncertain parkinsonism from a tertiary referral center in Mexico City.

MATERIALS AND METHODS

Patients who underwent [11C]DTBZ PET brain scan due to clinically uncertain parkinsonism where divided into two groups: PD or non-PD. A scan was considered positive when visual assessment revealed a decrease in [11C]DTBZ uptake typical for PD; a scan was considered negative when visual assessment showed no decrease in [11C]DTBZ uptake or showed a decrease in tracer uptake in a non-PD pattern. Sensitivity, specificity, and positive and negative predictive values were calculated using a 2 × 2 table, with a 95% confidence interval.

RESULTS

A total of 39 patients were included in the study. 14 PET studies were deemed positive and 25 PET studies were deemed negative; 12 true positives and 23 true negatives were found. This yielded a sensitivity of 92.9% (95% CI, 66.1-99.8), specificity of 92% (95% CI, 74-99), PPV of 86.7% (95% CI, 63.1-96.1), and NPV of 95.8% (95% CI, 79.1-98.4).

CONCLUSIONS

The [11C]DTBZ PET has an excellent accuracy for differentiating idiopathic PD from other disorders.

摘要

背景

单光子发射计算机断层扫描和正电子发射断层扫描（PET）已被证明有助于将帕金森病（PD）与其他运动障碍区分开来，其灵敏度高达95%。

目的

本研究的目的是确定[11C]DTBZ PET成像在墨西哥城一家三级转诊中心临床诊断不明确的帕金森综合征患者中的准确性。

材料与方法

因临床诊断不明确的帕金森综合征而接受[11C]DTBZ PET脑扫描的患者分为两组：PD组或非PD组。当视觉评估显示[11C]DTBZ摄取减少，呈现典型的PD表现时，扫描被视为阳性；当视觉评估显示[11C]DTBZ摄取没有减少或显示示踪剂摄取减少但为非PD模式时，扫描被视为阴性。使用2×2表格计算灵敏度、特异性、阳性预测值和阴性预测值，并给出95%置信区间。

结果

本研究共纳入39例患者。14例PET研究被视为阳性，25例PET研究被视为阴性；发现12例假阳性和23例假阴性。这得出灵敏度为92.9%（95%CI，66.1-99.8），特异性为92%（95%CI，74-99），阳性预测值为86.7%（95%CI，63.1-96.1），阴性预测值为95.8%（95%CI，79.1-98.4）。