Neurol. pro Praxi, 2004; 4: 218-221

SPECT v diagnostice parkinsonových syndromů

prof. Dr. Univ. Walter Pirker
Neurologische Abteilung der Krankenanstalt Rudolfstiftung, Wien

Keywords: SPECT, Parkinsonova nemoc, dopamin, bazální ganglia.

Published: December 31, 2004  Show citation

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Pirker UW. SPECT v diagnostice parkinsonových syndromů. Neurol. praxi. 2004;7(4):218-221.

Diferenciální diagnostika parkinsonových syndromů má z terapeutických a prognostických důvodů velký význam. Postmortální vyšetření ukázala, že spolehlivost pro klinické diagnózy Parkinsonovy nemoci samotné ve specializovaných centrech a při dodržování striktních kritérií je maximálně 90 %. Esenciální tremor a jiné tremorové syndromy, medikamentózně indukovaný parkinsonský syndrom, vaskulární parkinsonský syndrom, parkinsonské syndromy v rámci onemocnění demencí a atypická parkinsonská onemocnění degenerativní etiologie jako multisystémová atrofie nejsou hojně správně diagnostikovány. Vyšetření SPECT s dopamintransportujícími ligandy jako [123I]beta-CIT dovolují již v časném stadiu spolehlivou dokumentaci dopaminergní degenerace u idiopatické Parkinsonovy nemoci (PN) a u atypických parkinsonských onemocnění, a tím dostatečné odlišení od nedegenerativních parkinsonských syndromů s třesem. Dopamin transporterová SPECT vyšetření umožňují kromě toho diferencování demence s Lewyho tělísky od Alzheimerovy demence. SPECT vyšetření postsynaptických D2 receptorů s [123I]IBMZ může být přínosné k diferenciální diagnóze mezi idiopatickou Parkinsonovou nemoci a multisystémovou atrofií ev. progresivní supranukleární paralýzou.

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