期刊
RADIOLOGY
卷 265, 期 1, 页码 240-247出版社
RADIOLOGICAL SOC NORTH AMERICA
DOI: 10.1148/radiol.12112723
关键词
-
资金
- GE Healthcare
- Siemens
- Avid Radiopharmaceuticals
Purpose: To determine whether cardiac sympathetic denervation in idiopathic Parkinson disease (IPD) affects the left ventricle in a distinct regional pattern versus a more global pattern with use of carbon 11 (C-11) meta-hydroxyephedrine (HED) positron emission tomography (PET). Materials and Methods: This prospective study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from all subjects. Cardiac PET was performed with C-11 HED in 27 patients with IPD (20 men and seven women aged 50-74 years; mean age, 62 years +/- 6 [standard deviation]). C-11 HED retention indexes (RIs), which reflect nerve density and integrity, were determined. RIs for 33 healthy control subjects (15 men and 18 women aged 20-78 years; mean age, 47 years +/- 17) were used as a control database. Patients with IPD were compared with control subjects by using z score analysis. Global and segmental measurements of sympathetic denervation were expressed as percentage extent, z score severity, and severity-extent product (SEP). Group comparisons were performed with the Student t test. Results: The mean C-11 HED RI was 0.086 mL of blood per minute per milliliter tissue +/- 0.015 for control subjects and 0.043 mL of blood per minute per milliliter tissue +/- 0.016 for patients with IPD (P < .0001). When compared with normative data from the control database, profound cardiac denervation (global extent > 50%) was seen in most patients (19 of 27 patients, 70%). Four patients had normal C-11 HED studies and four had mild denervation (global extent < 25%). The mean global denervation extent was 62% +/- 38, the mean severity z score was -2.7 +/- 1.2, and the mean SEP was -202 +/- 131 (range, -358 to 0). Segmental analysis revealed relative sparing of anterior and proximal septal segments (mean extent, 48%-51%; mean severity z score, -2.47 to -2.0; mean SEP, -167 to -139), with lateral and proximal inferior segments more severely affected (mean extent, 68%-73%; mean severity z score, -2.8 to -2.62; mean SEP, -271 to -230). Patients with normal findings or preserved denervation did not significantly differ in mean age (t = 1.09) or disease duration (t = 0.44) compared to patients with severe sympathetic denervation. Conclusion: Cardiac sympathetic denervation in IPD is extensive, with a segmental pattern that involves the proximal lateral left ventricular wall most severely, with relative sparing of the anterior and proximal septal walls. (C) RSNA, 2012
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