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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Transcranial sonography and [18F]fluorodeoxyglucose positron emission tomography for the differential diagnosis of parkinsonism: A head-to-head comparison
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Transcranial sonography and [18F]fluorodeoxyglucose positron emission tomography for the differential diagnosis of parkinsonism: A head-to-head comparison

机译：经颅超声检查和[18F]氟脱氧葡萄糖正电子发射断层扫描对帕金森病的鉴别诊断：头对头比较

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Background and purpose: Brain imaging with positron emission tomography using [18F]fluorodeoxyglucose (FDG-PET) and transcranial B-mode sonography (TCS) improves the differential diagnosis of parkinsonism. The diagnostic merits of these approaches in identifying and differentiating atypical parkinsonian syndromes (APS) are compared. Methods: Data were included from 36 patients with clinically suspected APS who underwent PET and TCS. FDG-PET scans were analyzed by visual assessment (including voxel-based statistical maps) of a priori defined disease-specific metabolic patterns. Sonographers achieved diagnoses according to pre-defined criteria for echogenicities of the substantia nigra and lenticular nucleus, and third ventricle diameter. Patients with APS were identified and allocated to the subgroups multiple system atrophy (MSA), progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD). Results: After a median follow-up period of 9 months, the final clinical diagnoses (reference standard) were Parkinson's disease, n = 15; MSA, n = 9; PSP, n = 7; and CBD, n = 5 (n = 21 APS in total). Six patients (4 APS) showed an insufficient bone window for TCS. In the remaining 30 patients, sensitivity/specificity for diagnosing APS were 82%/100% and 82%/85% for FDG-PET and TCS, respectively. Diagnostic accuracies did not differ between FDG-PET (90%) and TCS (83%; P = 0.69). Likewise, overall accuracy of subgroup classification (non-APS, MSA, PSP and CBD) did not differ between modalities (FDG-PET 87% and TCS 83%; P = 1.00). Conclusions: FDG-PET and TCS show comparable accuracies for differential diagnosis of neurodegenerative parkinsonism. This preliminary study supports the use of TCS and warrants further prospective validation.
机译：背景与目的：使用[18F]氟脱氧葡萄糖（FDG-PET）和经颅B型超声检查（TCS）进行的正电子发射断层扫描术对大脑进行成像，可改善帕金森综合征的鉴别诊断。比较了这些方法在识别和区分非典型帕金森综合症（APS）中的诊断优点。方法：数据来自36例行PET和TCS的临床疑似APS患者。通过视觉评估（包括基于体素的统计图）对先验定义的疾病特异性代谢模式进行分析，分析FDG-PET扫描。超声医师根据黑质和双凸透镜核的回声性以及第三脑室直径的预定标准进行了诊断。确定患有APS的患者，并将其分配至多系统萎缩（MSA），进行性核上性麻痹（PSP）或皮质基底变性（CBD）的亚组。结果：中位随访9个月后，最终临床诊断（参考标准）为帕金森氏病，n = 15。 MSA，n = 9; PSP，n = 7;和CBD，n = 5（n =总共21 APS）。 6名患者（4 APS）的TCS骨窗不足。在其余30例患者中，FDG-PET和TCS诊断APS的敏感性/特异性分别为82％/ 100％和82％/ 85％。 FDG-PET（90％）和TCS（83％; P = 0.69）之间的诊断准确性无差异。同样，各组之间亚组分类（非APS，MSA，PSP和CBD）的总体准确性也没有差异（FDG-PET为87％，TCS为83％; P = 1.00）。结论：FDG-PET和TCS在神经变性帕金森病的鉴别诊断方面具有可比的准确性。这项初步研究支持TCS的使用，并需要进一步的前瞻性验证。

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