CAJ | 학술논문

目的观察帕金森病(PD)患者黑质超声(TCS)与脑多巴胺转运体(DAT)代谢脑正电子发射计算机断层显像(PET)是否具有一致性.方法本研究连续筛选2012年3-10月在天坛医院就诊的拟诊帕金森病患者,进行脑11C-CFT-PET显像和黑质超声检查,应用Kappa一致性分析检验TCS与PET结果的一致性.结果 53例患者完成了TCS与DAT-PET检查,TCS相对于PET检查的灵敏度68.75％,特异度40.00％,阳性预测值91.67％,阴性预测值11.76％,PET与TCS一致性检验Kappa值为0.042,P=0.69,P ＞0.05.结论对于临床诊断PD的患者,TCS结果阳性对PET阳性有较高预测价值,而TCS结果阴性时,不能排除PD可能,需要行DAT-PET检查进一步明确诊断.
목적 관찰파금삼병(PD)환자흑질초성(TCS)여뇌다파알전운체(DAT)대사뇌정전자발사계산궤단층현상(PET)시부구유일치성.방법 본연구련속사선2012년3-10월재천단의원취진적의진파금삼병환자,진행뇌11C-CFT-PET현상화흑질초성검사,응용Kappa일치성분석검험TCS여PET결과적일치성.결과 53례환자완성료TCS여DAT-PET검사,TCS상대우PET검사적령민도68.75％,특이도40.00％,양성예측치91.67％,음성예측치11.76％,PET여TCS일치성검험Kappa치위0.042,P=0.69,P ＞0.05.결론 대우림상진단PD적환자,TCS결과양성대PET양성유교고예측개치,이TCS결과음성시,불능배제PD가능,수요행DAT-PET검사진일보명학진단.
Objective To evaluate the consistency of dopamine transporter (DAT) positron emission tomography (PET) versus transcranial sonography (TCS) of Parkinson disease (PD) patients.Methods A total of 53 clinically diagnosed idopathic PD patients from Beijing Tiantan Hospital underwent 11C-CFT PET and transcranial sonography (TCS).Asymmetric reduced dopaminergic function was a positive result of PET while unilateral hyperechoic area larger than 0.2 cm2 a positive result of TCS.Kappa test was used to evaluate the consistency of two methods.Results Among them,36 patients (67.92％) were TCS positive while 17 patients (32.08％) TCS negative.There were 48 patients (90.57％) with positive PET whereas PET was negative for 5 patients (9.43％).TCS and PET were both positive in 33 patients (62.26％) while 2 (3.77％) yielded a double negative result.As compared with the PET results,the sensitivity,specificity,positive predictive value and negative predictive value of TCS were 68.75％,40.00％,91.67％ and 11.76％ respectively.For Kappa test,Kappa =0.042,P =0.690,P ＞ 0.05.It inferred a poor consistency.Conclusion TCS has a high predictive value for PET positive PD patients.For clinically diagnosed PD patients,a positive TCS result highly predicts PD without DAT-PET.However a negative TCS result can not rule out the possibility of PD.DAT-PET needs to be performed for further confirmation.