Diffusion weighted imaging best discriminates PD from MSA-P: A comparison with tilt table testing and heart MIBG scintigraphy.
Identifieur interne : 001D10 ( Ncbi/Checkpoint ); précédent : 001D09; suivant : 001D11Diffusion weighted imaging best discriminates PD from MSA-P: A comparison with tilt table testing and heart MIBG scintigraphy.
Auteurs : Martin Köllensperger [Autriche] ; Klaus Seppi ; Claudia Liener ; Sylvia Boesch ; Dirk Heute ; Katherina J. Mair ; Joerg Mueller ; Martin Sawires ; Christoph Scherfler ; Michael F. Schocke ; Eveline Donnemilier ; Irene Virgolini ; Gregor K. Wenning ; Werner Poewe [Autriche]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- 3-Iodobenzylguanidine (diagnostic use), 3-Iodobenzylguanidine (pharmacokinetics), Aged, Analysis of Variance, Area Under Curve, Case-Control Studies, Diffusion Magnetic Resonance Imaging (methods), Heart (physiopathology), Heart (radionuclide imaging), Humans, Middle Aged, Multiple System Atrophy (diagnosis), Multiple System Atrophy (physiopathology), Parkinson Disease (diagnosis), Parkinson Disease (physiopathology), Radiopharmaceuticals (diagnostic use), Radiopharmaceuticals (pharmacokinetics), Sensitivity and Specificity, Tilt-Table Test (methods), Time Factors.
- MESH :
- chemical , diagnostic use : 3-Iodobenzylguanidine, Radiopharmaceuticals.
- chemical , pharmacokinetics : 3-Iodobenzylguanidine, Radiopharmaceuticals.
- diagnosis : Multiple System Atrophy, Parkinson Disease.
- methods : Diffusion Magnetic Resonance Imaging, Tilt-Table Test.
- physiopathology : Heart, Multiple System Atrophy, Parkinson Disease.
- radionuclide imaging : Heart.
- Aged, Analysis of Variance, Area Under Curve, Case-Control Studies, Humans, Middle Aged, Sensitivity and Specificity, Time Factors.
Abstract
Both diffusion weighted magnetic resonance imaging (DWI) of the basal ganglia and meta-iodobenzylguanidin (MIBG) scintigraphy of the heart have been reported useful in the differential diagnosis of patients with Parkinson's disease (PD) vs. the parkinson variant of multiple system atrophy (MSA-P). Their diagnostic value, however, has never been directly compared in patients with parkinsonism and autonomic dysfunction. We have studied 9 patients with PD and 9 patients with MSA-P matched for age and disease severity. Regional trace of the diffusion tensor values were determined in the putamina. Cardiac MIBG uptake was quantified by comparing regions of interest over heart and mediastinum Heart/Mediastinum (H/M) ratio. Furthermore, all patients underwent tilt testing. PD patients showed significantly lower H/M ratios than normal controls; however, there was considerable overlap between the two patient groups. We did not detect any significant differences of blood pressure response to passive tilt between the two patient groups. Sensitivity of MIBG scintigraphy versus DWI for the differentiation of MSA-P from PD was 55.6% vs. 100%, specificity 88.8% vs. 100%, and area under the curve 0.802 vs. 1.000. Our data suggest that DWI is superior to both tilt table testing and MIBG scintigraphy in the differential diagnosis of PD versus MSA-P.
DOI: 10.1002/mds.21614
PubMed: 17579357
Affiliations:
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<author><name sortKey="Kollensperger, Martin" sort="Kollensperger, Martin" uniqKey="Kollensperger M" first="Martin" last="Köllensperger">Martin Köllensperger</name>
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<term>Area Under Curve</term>
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<front><div type="abstract" xml:lang="en">Both diffusion weighted magnetic resonance imaging (DWI) of the basal ganglia and meta-iodobenzylguanidin (MIBG) scintigraphy of the heart have been reported useful in the differential diagnosis of patients with Parkinson's disease (PD) vs. the parkinson variant of multiple system atrophy (MSA-P). Their diagnostic value, however, has never been directly compared in patients with parkinsonism and autonomic dysfunction. We have studied 9 patients with PD and 9 patients with MSA-P matched for age and disease severity. Regional trace of the diffusion tensor values were determined in the putamina. Cardiac MIBG uptake was quantified by comparing regions of interest over heart and mediastinum Heart/Mediastinum (H/M) ratio. Furthermore, all patients underwent tilt testing. PD patients showed significantly lower H/M ratios than normal controls; however, there was considerable overlap between the two patient groups. We did not detect any significant differences of blood pressure response to passive tilt between the two patient groups. Sensitivity of MIBG scintigraphy versus DWI for the differentiation of MSA-P from PD was 55.6% vs. 100%, specificity 88.8% vs. 100%, and area under the curve 0.802 vs. 1.000. Our data suggest that DWI is superior to both tilt table testing and MIBG scintigraphy in the differential diagnosis of PD versus MSA-P.</div>
</front>
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