Camparison of diffusion-weighted imaging and [123I]IBZM-SPECT for the differentiation of patients with the Parkinson variant of multiple system atrophy from those with Parkinson's disease

被引:70
作者
Seppi, K
Schocke, MFH
Donnemiller, E
Esterhammer, R
Kremser, C
Scherfler, C
Diem, A
Jaschke, W
Wenning, GK
Poewe, W
机构
[1] Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, Austria
[2] Univ Innsbruck, Dept Radiol, A-6020 Innsbruck, Austria
[3] Univ Innsbruck, Dept Nucl Med, A-6020 Innsbruck, Austria
关键词
Parkinson's disease; multiple system atrophy; diffusion-weighted imaging; (123)I]IBZM-SPECT; dopamine D2 receptors;
D O I
10.1002/mds.20229
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Both dopamine D2 receptor (D2R) binding single-photon emission computed tomography (SPELT) with [(123)I]iodobenzamide (IBZM) and diffusion-weighted imaging (DWI) have been shown to contribute to the differential diagnosis of patients with the Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD). We aimed to compare these two routinely available functional imaging modalities in differentiating patients with MSA-P from PD. For this purpose, results obtained by DWI and IBZM-SPELT were intraindividually compared in a cross-sectional study of 15 MSA-P and 17 PD patients matched for age and disease duration. The activity ratios of striatal to frontal cortex uptake (S/FC ratio) were used as a semiquantitative measure of the relative density of basal ganglia dopamine receptors labeled by IBZM. Regional apparent diffusion coefficients (rADC) were determined in the striatum. MSA-P patients had significantly lower S/FC ratios and significantly higher striatal rADCs than both PD patients and healthy volunteers. There were no significant differences in S/FC ratios and striatal rADC between PD patients and healthy volunteers. Sensitivity of IBZM-SPECT versus DWI for the differentiation of MSA-P from PD was 80% versus 93%, specificity 71% versus 100%, the predictive accuracy 75% versus 97%, the positive predictive value 71% versus 100%, and the negative predictive value 80% versus 94%. Striatal rADCs had a significant higher overall predictive accuracy than D2R binding with IBZM. In summary, our data suggest that DWI may be more accurate compared to IBZM-SPELT in the differential diagnosis of MSA-P versus PD. (C) 2004 Movement Disorder Society.
引用
收藏
页码:1438 / 1445
页数:8
相关论文
共 54 条
[1]   [C-11] RACLOPRIDE AND POSITRON EMISSION TOMOGRAPHY IN PREVIOUSLY UNTREATED PATIENTS WITH PARKINSONS-DISEASE - INFLUENCE OF L-DOPA AND LISURIDE THERAPY ON STRIATAL DOPAMINE D-2-RECEPTORS [J].
ANTONINI, A ;
SCHWARZ, J ;
OERTEL, WH ;
BEER, HF ;
MADEJA, UD ;
LEENDERS, KL .
NEUROLOGY, 1994, 44 (07) :1325-1329
[2]   Long-term changes of striatal dopamine D-2 receptors in patients with Parkinson's disease: A study with positron emission tomography and [C-11]Raclopride [J].
Antonini, A ;
Schwarz, J ;
Oertel, WH ;
Pogarell, O ;
Leenders, KL .
MOVEMENT DISORDERS, 1997, 12 (01) :33-38
[3]   Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson's disease [J].
Antonini, A ;
Leenders, KL ;
Vontobel, P ;
Maguire, RP ;
Missimer, J ;
Psylla, M ;
Günther, I .
BRAIN, 1997, 120 :2187-2195
[4]   Brain magnetic resonance imaging in multiple-system atrophy and Parkinson disease - A diagnostic algorithm [J].
Bhattacharya, K ;
Saadia, D ;
Eisenkraft, B ;
Yahr, M ;
Olanow, W ;
Drayer, B ;
Kaufmann, H .
ARCHIVES OF NEUROLOGY, 2002, 59 (05) :835-842
[5]   Imaging of the dopaminergic neurotransmission system using single-photon emission tomography and positron emission tomography in patients with parkinsonism [J].
Booij, J ;
Tissingh, G ;
Winogrodzka, A ;
van Royen, EA .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE, 1999, 26 (02) :171-182
[6]   STRIATAL D2 RECEPTOR STATUS IN PATIENTS WITH PARKINSONS-DISEASE, STRIATONIGRAL DEGENERATION, AND PROGRESSIVE SUPRANUCLEAR PALSY, MEASURED WITH C-11 RACLOPRIDE AND POSITRON EMISSION TOMOGRAPHY [J].
BROOKS, DJ ;
IBANEZ, V ;
SAWLE, GV ;
PLAYFORD, ED ;
QUINN, N ;
MATHIAS, CJ ;
LEES, AJ ;
MARSDEN, CD ;
BANNISTER, R ;
FRACKOWIAK, RSJ .
ANNALS OF NEUROLOGY, 1992, 31 (02) :184-192
[7]  
BRUCKE T, 1993, ADV NEUROL, V60, P494
[8]  
BRUCKE T, 1991, J CEREBR BLOOD F MET, V11, P220
[9]  
Chun T, 2000, AM J NEURORADIOL, V21, P1078
[10]   DOPA RESISTANCE IN MULTIPLE-SYSTEM ATROPHY - LOSS OF POSTSYNAPTIC D2 RECEPTORS [J].
CHURCHYARD, A ;
DONNAN, GA ;
HUGHES, A ;
HOWELLS, DW ;
WOODHOUSE, D ;
WONG, JYF ;
KALNINS, RM ;
MENDELSOHN, FAO ;
PAXINOS, G .
ANNALS OF NEUROLOGY, 1993, 34 (02) :219-226