Nuklearmedizinische Bildgebung bei zerebralen Erkrankungen

Zusammenfassung

Die Single Photonen Emissions Tomographie (SPECT) und die Positronen Emissions Tomographie (PET) haben sich bei der Diagnose neurodegenerativer Hirnerkrankungen bewährt. Zur Anwendung kommen entweder Blutflussmessungen über der grauen Hirnsubstanz, oder aber Bestimmungen rezeptorspezifischer Marker, wobei der Schwerpunkt dieser Untersuchungstechniken bei der Differenzialdiagnose unterschiedlicher zerebraler Erkrankungen und der Therapiebeurteilung liegt. SPECT und PET sind sensitive Methoden zur Früherkennung neurodegenerativer Erkrankungen und subkortikaler Veränderungen im Bereich der Basalganglien. Ziel dieser Arbeit ist es, einen kleinen Überblick über die nuklearmedizinischen Möglichkeiten der Bildgebung bei Patienten mit Verdacht auf kortikale (z. B. M. Alzheimer etc.) und subkortikale neurodegenerative Erkrankungen (M. Parkinson, MP; Demenz mit Lewy-Körperchen, DLB) zu geben.

Summary

Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are important tools in the differential diagnosis and therapeutic monitoring of cognitive disorders. SPECT and PET are highly sensitive methods for the early diagnosis of underlying neurodegeneration and the functional changes in the basal ganglia. Early and reliable diagnosis will become even more relevant with the development of options in the causal treatment of dementias, which would exert their most beneficial effects well before the onset of clinical symptoms. This review provides a brief survey on currently available methods of nuclear imaging in cortical (Alzheimer's disease) and subcortical forms of neurodegenerative dementia (Parkinson's disease; dementia with Lewy bodies).

Schlüsselwörter

SPECT - PET - DaTSCAN - Alzheimer - Parkinson - Demenz mit Lewy-Körperchen

Key words

SPECT - PET - DaTSCAN - Alzheimer dementia - Parkinson disease - dementia with Lewy-bodies

Literatur

• 1 Alafuzoff I. The pathology of dementias: an overview.  Acta Neurol Scand Suppl. 1992;  139 8-15
• 2 Barthel H, Hermann W, Kluge R. et al . Concordant pre- and postsynaptic deficits of dopaminergic neurotransmission in neurologic Wilson disease.  AJNR Am J Neuroradiol. 2003;  24 234-238
• 3 Barthel H, Sorger D, Kühn H J. et al . Differential alteration of the nigrostriatal dopaminergic system in Wilson’s disease investigated with [123I]ss-CIT and high-resolution SPET.  Eur J Nucl Med. 2001;  28 1656-1663
• 4 Benamer T S, Patterson J, Grosset D G. et al . Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group.  Mov Disord. 2000;  15 503-510
• 5 Benamer H T, Patterson J, Wyper D J. et al . Correlation of Parkinson’s disease severity and duration with 123I-FP-CIT SPECT striatal uptake.  Mov Disord. 2000;  15 692-698
• 6 Catafau A M, Lomeña F J, Pavia J. et al . Regional cerebral blood flow pattern in normal young and aged volunteers: a 99mTc-HMPAO SPET study.  Eur J Nucl Med. 1996;  23 1329-1337
• 7 Dodel R C, Höffken H, Möller J C. et al . Dopamine transporter imaging and SPECT in diagnostic work-up of Parkinson’s disease: a decision-analytic approach.  Mov Disord. 2003;  18, Suppl 7 S52-62
• 8 Drzezga A, Grimmer T, Henriksen G. et al . Imaging of amyloid plaques and cerebral glucose metabolism in semantic dementia and Alzheimer’s disease.  Neuroimage. 2007; 
• 9 Herholz K, Schopphoff H, Schmidt M. et al . Direct comparison of spatially normalized PET and SPECT scans in Alzheimer’s disease.  J Nucl Med. 2002;  43 21-26
• 10 Ishii K. Clinical application of positron emission tomography for diagnosis of dementia.  Ann Nuc Med. 2002;  16 515-525
• 11 Kubota T, Ushijima Y, Okuyama C. et al . A region-of-interest template for three-dimensional stereotactic surface projection images: initial application to the analysis of Alzheimer’s disease and mild cognitive impairment.  Nucl Med Commun. 2006;  27 37-44
• 12 Mosconi L. Brain glucose metabolism in the early and specific diagnosis of Alzheimer’s disease. FDG-PET studies in MCI and AD.  Eur J Nucl Med Mol Imaging. 2005;  32 486-510
• 13 Neary D, Snowden J S, Gustafson L. et al . Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria.  Neurology. 1998;  51 (6) 1546-1554
• 14 Verstappen C C, Bloem B R, Haaxma C A. et al . Diagnostic value of asymmetric striatal D2 receptor upregulation in Parkinson’s disease: an [123I]IBZM and [123I]FP-CIT SPECT study.  Eur J Nucl Med Mol Imaging. 2007;  34 502-507
• 15 Walker Z, Costa D C, Walker R W. et al . Differentiation of dementia with Lewy bodies from Alzheimer’s disease using a dopaminergic presynaptic ligand.  J Neurol Neurosurg Psychiatry. 2002;  73 134-140
• 16 Walker Z, Jaros E, Walker R W. et al . Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy.  J Neurol Neurosurg Psychiatry. 2007;  78 1176-1181