Diagnostische Bildgebung des dopaminergen Systems

Zusammenfassung

Die Arbeit gibt einen Überblick über den Einsatz der PET- und SPECT-Bildgebung des prä- und postsynaptischen dopaminergen Systems bei klinisch wichtigen Bewegungsstörungen. Die typischen Untersuchungsbefunde bei neurodegenerativen Parkinson-Syndromen (idiopathisch und nicht-idiopathisch), symptomatischen Parkinson-Syndromen und wichtigen Differenzialdiagnosen wie vaskuläres Parkinson-Syndrom und essenziellem Tremor werden detailliert beschrieben. Neben der Zusammenstellung in der Literatur publizierter Erkenntnisse wird besonders auf den klinisch praktischen Stellenwert der Methoden eingegangen. Dazu werden die diagnostische Aussagekraft und Limitationen der Methoden bewertet und die in Leitlinien festgehaltenen Einsatzbereiche angesprochen.

Abstract

This paper gives an overview on the use of PET- and SPECT-imaging of the pre- and postsynaptic dopaminergic system in the diagnostic work-up of patients with clinically important movement disorders. Typical findings in neurodegenerative parkinsonism (idiopathic, non-idiopathic), in secondary parkinsonism and major differential diagnoses such as vascular parkinsonism and essential tremor are described in detail. Apart from summarizing the body of knowledge in the literature the current clinical impact of the methods is addressed. In this context the diagnostic accuracy and limitations of the mentioned imaging tools are discussed together with their appropriate use in accordance with current guidelines.

Schlüsselwörter

Positronenemissions-tomografie - Single-Photon-Emissions- Computertomografie - Parkinson-Syndrome - dopaminerges System - Dopamintransporter - Dopaminrezeptoren

Key words

positron-emission tomography - single-photon-emission-tomography - movement disorders - dopaminergic system - dopamine transporter - dopamine receptor

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