Shamir Medical Center, Assaf Harofeh, Israel.
Nuclear Medicine Department, Sheba Medical Center, Tel-Hashomer, affiliated to Tel-Aviv University, Israel.
J Neurol Sci. 2022 May 15;436:120220. doi: 10.1016/j.jns.2022.120220. Epub 2022 Mar 9.
The current review analyzed Parkinson's disease-related (PD) literature published from 1817 to 2021 and specifically concentrated on imaging-related works published from the 1960s to 2021. We analyzed the history of PD-related imaging development, its current condition, and pointed out some understudied aspects to be investigated in the future. The present review is specifically concentrated on nuclear imaging techniques. The available imaging armamentarium for PD investigation is very broad, variable, and diversified and includes structural, diffusion-weighted and diffusion tensor, resting-state, and task-based functional MRI, proton magnetic resonance spectroscopy, transcranial B-mode sonography, single-photon emission CT (SPECT), and positron emission tomography (PET). Specifically, PET is a reliable tool for quantifying nigrostriatal functions, glucose metabolism, amyloid, tau, and α-synuclein molecular imaging, as well as neuroinflammation. Besides F-DOPA and F-FDG, PET and SPECT use various other radiopharmaceuticals. Also, some studies have demonstrated that myocardial I-MIBG scintigraphy can be useful for the early differential diagnosis of patients with PD from other atypical PD. However, in addition to further perfecting of differential diagnosis imaging tools, some aspects of etiology (PD genetics), pathology (the pons and medulla), pathophysiology (neuroinflammation), and early diagnosis of PD remain understudied. The currently available set of neuroimaging tools can provide adequate imaging data for early diagnosis, differential diagnosis, progression assessment, and treatment assessment of PD. To adjust this armamentarium to routine clinical needs, there is an urgent need for the generally accepted protocol for PD-related imaging investigations. Closer cooperation and data exchange between radiologists and pathologists are desirable.
本文回顾了 1817 年至 2021 年发表的与帕金森病相关的文献，并特别关注了 20 世纪 60 年代至 2021 年发表的与影像学相关的研究。我们分析了 PD 相关影像学发展的历史、现状，并指出了一些未来需要研究的未被充分研究的方面。本综述特别关注核医学成像技术。目前 PD 研究的影像学手段非常广泛、多样和多样化，包括结构成像、弥散加权和弥散张量成像、静息态和任务态功能磁共振成像、质子磁共振波谱、经颅 B 型超声、单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）。具体而言，PET 是一种可靠的工具，可用于定量评估黑质纹状体功能、葡萄糖代谢、淀粉样蛋白、tau 和α-突触核蛋白的分子成像，以及神经炎症。除了 F-DOPA 和 F-FDG 之外，PET 和 SPECT 还使用其他各种放射性药物。此外，一些研究表明，心肌 I-MIBG 闪烁显像对于将 PD 患者与其他非典型 PD 患者进行早期鉴别诊断可能有用。然而，除了进一步完善鉴别诊断影像学工具外，病因学（PD 遗传学）、病理学（脑桥和延髓）、病理生理学（神经炎症）和 PD 的早期诊断等方面仍需要进一步研究。目前可用的一系列神经影像学工具可以为 PD 的早期诊断、鉴别诊断、进展评估和治疗评估提供充分的影像学数据。为了将这一工具集调整到常规临床需求，迫切需要制定与 PD 相关的影像学研究的通用协议。放射科医生和病理科医生之间更密切的合作和数据交流是可取的。
