临床实践中[^(123)I]β-CITSPECT的作用  

How useful is [^(123)I]β-CIT SPECT in clinical practice?

作　　者：Eerola J. Tienari P.J. Kaakkola S. 邓剑平 

机构地区：[1]Dr.Department of Neurology, HUCH, PO Box 340, FIN-00029 HUS, Helsinki, Finland

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第12期40-41,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objective: To assess the accuracy and clinical usefulness of [ 123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane)-SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100%sensitive and specific for the diagnosis in younger patients (age < 55 years). In older patients (age > 55 years)-specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.Objective: To assess the accuracy and clinical usefulness of [ 123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane)-SPECT in the differential diagnosis of Parkinson's disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson's disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson's disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson's disease group. In the P+and DLB groups the striatal uptake ratios overlapped those of the Parkinson's disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson's disease as was previously believed, but it was 100%sensitive and specific for the diagnosis in younger patients (age < 55 years). In older patients (age > 55 years)-specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.

关 键 词：临床实践 CITSPECT 特发性震颤 肌张力障碍 帕金森综合征 锥体外系疾病 纹状体 鉴别诊断 运动障碍 壳核 

分 类 号：R742.5[医药卫生—神经病学与精神病学]