PDF(Pubmed)
Abstract：
BACKGROUND: Multiple system atrophy (MSA) is subdivided into two types: MSA-P (parkinsonian) and MSA-C (cerebellar). Brain SPECT allows for the detection of nigrostriatal involvement, even in the early stages. To date, the scientific literature does not show a consensus on how to follow-up MSA, especially MSA-C. Our aim was to analyze the diagnostic effectiveness of repeat [123I]Ioflupane SPECT for the follow-up of MSA.
METHODS: A longitudinal observational study on 22 MSA patients (11 males and 11 females).
RESULTS: Significant changes were obtained in the quantitative SPECT assessments in the three Striatum/Occipital indices. The qualitative SPECT diagnosis did not show differences between the initial and evolving SPECT, but the neurologist\'s clinical suspicion did. Our results showed a brain deterioration of around 31% at 12 months, this being the optimal cut-off for differentiating a diseased subject (capable of solving diagnostic error rate). Previous imaging tests were inconclusive, as they showed less deterioration in the SPECT and quantitative assessments with respect to the group of confirmed patients. Repeated SPECT increased the diagnostic sensitivity (50% vs. 75%) and positive predictive value (72.73% vs. 77%). In addition, repeated SPECT proved decisive in the diagnosis of initial inconclusive cases.
CONCLUSIONS: Repeat SPECT at 12 months proves useful in the diagnosis and follow-up of MSA.
METHODS: A longitudinal observational study on 22 MSA patients (11 males and 11 females).
RESULTS: Significant changes were obtained in the quantitative SPECT assessments in the three Striatum/Occipital indices. The qualitative SPECT diagnosis did not show differences between the initial and evolving SPECT, but the neurologist\'s clinical suspicion did. Our results showed a brain deterioration of around 31% at 12 months, this being the optimal cut-off for differentiating a diseased subject (capable of solving diagnostic error rate). Previous imaging tests were inconclusive, as they showed less deterioration in the SPECT and quantitative assessments with respect to the group of confirmed patients. Repeated SPECT increased the diagnostic sensitivity (50% vs. 75%) and positive predictive value (72.73% vs. 77%). In addition, repeated SPECT proved decisive in the diagnosis of initial inconclusive cases.
CONCLUSIONS: Repeat SPECT at 12 months proves useful in the diagnosis and follow-up of MSA.
摘要：
背景：多系统萎缩（MSA）细分为两种类型：MSA-P（帕金森病）和MSA-C（小脑）。脑SPECT可以检测黑质纹状体受累，即使在早期阶段。迄今为止,科学文献没有显示出关于如何跟进MSA的共识，特别是MSA-C。我们的目的是分析重复[123I]碘氟平SPECT对MSA随访的诊断有效性。
方法：对22名MSA患者（11名男性和11名女性）进行纵向观察研究。
结果：在三个纹状体/枕骨指数的SPECT定量评估中获得了显着变化。定性SPECT诊断未显示初始和演进SPECT之间的差异，但神经科医生的临床怀疑确实如此.我们的结果显示，12个月时大脑退化约31%，这是区分患病受试者的最佳截止值（能够解决诊断错误率）。以前的影像学检查没有定论，因为他们在SPECT和定量评估中显示相对于确诊患者组较少恶化。重复SPECT提高了诊断灵敏度(50%vs.75%）和阳性预测值（72.73%vs.77%）。此外,重复的SPECT被证明对最初的不确定病例的诊断具有决定性意义。
结论：在12个月时重复SPECT被证明对MSA的诊断和随访有用。
方法：对22名MSA患者（11名男性和11名女性）进行纵向观察研究。
结果：在三个纹状体/枕骨指数的SPECT定量评估中获得了显着变化。定性SPECT诊断未显示初始和演进SPECT之间的差异，但神经科医生的临床怀疑确实如此.我们的结果显示，12个月时大脑退化约31%，这是区分患病受试者的最佳截止值（能够解决诊断错误率）。以前的影像学检查没有定论，因为他们在SPECT和定量评估中显示相对于确诊患者组较少恶化。重复SPECT提高了诊断灵敏度(50%vs.75%）和阳性预测值（72.73%vs.77%）。此外,重复的SPECT被证明对最初的不确定病例的诊断具有决定性意义。
结论：在12个月时重复SPECT被证明对MSA的诊断和随访有用。
