Departments of Nuclear Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea.
Institute of Convergence Bio-Health, Dong-A University, Busan, Republic of Korea.
PLoS One. 2020 Mar 5;15(3):e0229860. doi: 10.1371/journal.pone.0229860. eCollection 2020.
We have evaluated the clinical significance of the washout rate (WR) on I-123 MIBG scans through the analysis of the relationship between the I-123 MIBG scans and autonomic status in patients with Parkinson's disease (PD).
Sixty patients with clinical PD who had decreased HMR were enrolled. An autonomic symptom was evaluated using a head-up tilt test and the Composite Autonomic Severity Score (CASS). An I-123 MIBG scan and F-18 FP-CIT positron emission tomography (PET) were performed. All of the patients were classified into three groups according to the WR. The differences in patient characteristics and the imaging parameters among the three groups were evaluated, and a correlation analysis was also performed.
The frequency of orthostatic hypotension was significantly different among the three groups. The difference in systolic pressure (dSysPr) and the difference in diastolic pressure (dDiaPr) of group 3 was significantly larger than those of groups 1 and 2. From the correlation analysis, it can be seen that age, Hoehn and Yahr (H&Y) stage, dSysPr, and dDiaPr had a weak positive correlation with the WR. The total CASS score was significantly higher in group 3 compared with groups 1 and 2. The WR had a moderate positive correlation with the cardiosympathetic score and the total CASS score.
The WR is related to autonomic dysfunction. An I-123 MIBG cardiac scan is considered to be a good method to evaluate not only the differential diagnosis of Parkinson's disease but also the degree of autonomic dysfunction.
通过分析 123I-MIBG 扫描与帕金森病（PD）患者自主神经状态之间的关系，评估 123I-MIBG 扫描中的洗脱率（WR）的临床意义。
共纳入 60 例 HMR 降低的临床 PD 患者。采用直立倾斜试验和综合自主严重程度评分（CASS）评估自主症状。进行 123I-MIBG 扫描和 F-18 FP-CIT 正电子发射断层扫描（PET）。根据 WR 将所有患者分为三组。评估三组间患者特征和影像学参数的差异，并进行相关性分析。
三组间直立性低血压的发生率存在显著差异。组 3 的收缩压差值（dSysPr）和舒张压差值（dDiaPr）显著大于组 1 和组 2。相关性分析表明，年龄、Hoehn 和 Yahr（H&Y）分期、dSysPr 和 dDiaPr 与 WR 呈弱正相关。与组 1 和组 2 相比，组 3 的总 CASS 评分显著升高。WR 与心脏交感神经评分和总 CASS 评分呈中度正相关。
WR 与自主神经功能障碍有关。123I-MIBG 心脏扫描被认为是一种很好的方法，不仅可以评估帕金森病的鉴别诊断，还可以评估自主神经功能障碍的程度。
