心脏F-多巴胺PET可区分伴有直立性低血压的帕金森病与帕金森综合征多系统萎缩。
Cardiac F-Dopamine PET Distinguishes PD with Orthostatic Hypotension from Parkinsonian MSA.
作者信息
Lenka Abhishek, Lamotte Guillaume, Goldstein David S
机构信息
Department of Neurology Medstar Georgetown University Hospital Washington, DC USA.
Autonomic Medicine Section, National Institute of Neurological Disorders and Stroke (NINDS) National Institutes of Health (NIH) Bethesda Maryland USA.
出版信息
Mov Disord Clin Pract. 2021 Mar 23;8(4):582-586. doi: 10.1002/mdc3.13190. eCollection 2021 May.
BACKGROUND
Parkinson's disease with orthostatic hypotension (PD + OH) can be difficult to distinguish clinically from the parkinsonian form of multiple system atrophy (MSA-P). Previous studies examined cardiac sympathetic neuroimaging to differentiate PD from MSA but without focusing specifically on PD + OH versus MSA-P, which often is the relevant differential diagnostic issue.
OBJECTIVE
To investigate the utility of cardiac sympathetic neuroimaging by F-dopamine positron emission tomographic (PET) scanning for separating PD + OH from MSA-P.
METHODS
Cardiac F-dopamine PET data were analyzed from 50 PD + OH and 68 MSA-P patients evaluated at the NIH Clinical Center from 1990 to 2020. Noradrenergic deficiency was defined by interventricular septal F-dopamine-derived radioactivity <6000 nCi-kg/cc-mCi in the 5' frame with mid-point 8' after initiation of 3' tracer injection.
RESULTS
F-Dopamine PET separated the PD + OH from the MSA-P group with a sensitivity of 92% and specificity of 96%.
CONCLUSION
Cardiac F-dopamine PET scanning efficiently distinguishes PD + OH from MSA-P.
背景
帕金森病合并体位性低血压（PD + OH）在临床上可能难以与多系统萎缩帕金森综合征型（MSA-P）相区分。以往的研究通过心脏交感神经成像来鉴别帕金森病与多系统萎缩，但未特别关注PD + OH与MSA-P的鉴别，而这往往是相关的鉴别诊断问题。
目的
研究用F-多巴胺正电子发射断层扫描（PET）进行心脏交感神经成像对区分PD + OH与MSA-P的作用。
方法
分析了1990年至2020年在国立卫生研究院临床中心评估的50例PD + OH患者和68例MSA-P患者的心脏F-多巴胺PET数据。去甲肾上腺素能缺乏的定义为：在注射3'示踪剂后，于5'帧且中点为8'时，室间隔F-多巴胺衍生放射性<6000 nCi-kg/cc-mCi。
结果
F-多巴胺PET区分PD + OH组与MSA-P组的敏感性为92%，特异性为96%。
结论
心脏F-多巴胺PET扫描能有效区分PD + OH与MSA-P。
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