Hagen Johannes M, Scheifele Maximilian, Zacherl Mathias J, Katzdobler Sabrina, Bernhardt Alexander, Brendel Matthias, Levin Johannes, Höglinger Günter U, Clauß Sebastian, Kääb Stefan, Todica Andrei, Boening Guido, Fischer Maximilian
Department of Nuclear Medicine, Ludwig-Maximilians-University, 81377 Munich, Germany.
Department of Neurology, Ludwig-Maximilians-University, 81377 Munich, Germany.
Diagnostics (Basel). 2024 Dec 26;15(1):24. doi: 10.3390/diagnostics15010024.
: Iodo-metaiodobenzylguanidine single photon emission computed tomography/computed tomography (I-MIBG SPECT/CT) is used to evaluate the cardiac sympathetic nervous system in cardiac diseases such as arrhythmogenic right ventricular cardiomyopathy (ARVC) and α-synucleinopathies such as Parkinson's diseases. A common feature of these diseases is denervation. We aimed to compare quantitative and semi-quantitative cardiac sympathetic innervation using I-MIBG imaging of ARVC and α-synucleinopathies. : Cardiac innervation was assessed using I-MIBG SPECT/CT in 20 patients diagnosed with definite ARVC and 8 patients with clinically diagnosed α-synucleinopathies. Heart-to-mediastinum-ratio (H/M-ratio), as semi-quantitative, was evaluated. Additionally, standardized uptake value (SUV), as quantitative, was measured as SUV, SUV, and SUV in the left ventricle (LV), the right ventricle (RV), and in the global heart, based on a CT scan following quantitative image reconstruction. : The quantification of I-MIBG uptake in the LV, the RV, and the global heart was feasible in patients suffering from α-synucleinopathies. SUV, and SUV demonstrated a significant difference between ARVC and α-synucleinopathies across all regions, with the α-synucleinopathy group showing a lower uptake. In addition, the H/M ratio showed significantly lower uptake in patients with α-synucleinopathies than in patients with ARVC. : Patients with α-synucleinopathies demonstrate significantly lower cardiac innervation in semi-quantitative and quantitative examinations than ARVC patients. The comparison of semi-quantitative and quantitative examinations suggests that quantitative examination offers an advantage. Quantitative analysis can be performed separately for the LV, RV, and global heart. However, analyzing the LV or RV does not provide additional benefit over analyzing the global heart in distinguishing between α-synucleinopathies and ARVC. Considering the different clinical manifestations of these two diseases, the absolute SUV values should not be generalized across different pathologies, and disease-specific ranges should be used instead.
碘代间碘苄胍单光子发射计算机断层扫描/计算机断层扫描（I-MIBG SPECT/CT）用于评估心律失常性右室心肌病（ARVC）等心脏病以及帕金森病等α-突触核蛋白病中的心脏交感神经系统。这些疾病的一个共同特征是去神经支配。我们旨在通过I-MIBG成像比较ARVC和α-突触核蛋白病的心脏交感神经支配的定量和半定量情况。
对20例确诊为ARVC的患者和8例临床诊断为α-突触核蛋白病的患者使用I-MIBG SPECT/CT评估心脏神经支配情况。评估了作为半定量指标的心脏与纵隔比值（H/M比值）。此外，在定量图像重建后的CT扫描基础上，测量了作为定量指标的标准化摄取值（SUV），分别为左心室（LV）、右心室（RV）和全心的SUV、SUV和SUV。
在α-突触核蛋白病患者中，对LV、RV和全心的I-MIBG摄取进行定量分析是可行的。在所有区域，ARVC和α-突触核蛋白病之间的SUV和SUV存在显著差异，α-突触核蛋白病组的摄取较低。此外，α-突触核蛋白病患者的H/M比值摄取明显低于ARVC患者。
α-突触核蛋白病患者在半定量和定量检查中的心脏神经支配明显低于ARVC患者。半定量和定量检查的比较表明，定量检查具有优势。可以分别对LV、RV和全心进行定量分析。然而，在区分α-突触核蛋白病和ARVC方面，分析LV或RV与分析全心相比并没有额外的优势。考虑到这两种疾病的不同临床表现，不应将绝对SUV值推广到不同的病理情况，而应使用特定疾病的范围。
