DaTSCAN
Click on the Scan for larger image (in new window/tab)
Clinical Details - Case 2
Question 1
What is the classic triad of symptoms associated with Parkinson's Disease:
Answer
Bradykinesia, resting tremor and muscular rigidity.
Question 2
What is the pathological process that leads to the abnormal DaTSCAN findings in persons with PD?
Answer
Lewy Body deposition in the brainstem leading to loss of neurons projecting from the substania nigra to the corpus striatum (putamen in particular).
Question 3
What percentage of dopaminergic neurons have to be lost before clinical presentation?
Answer
50%. This means that marked abnormalities should be seen on DaTSCAN even in the earliest phases of disease manifestation. In addition imaging should be able to detect preclinical disease that is estimated as being in the order of 5 years before clinical presentation.
Question 4
Is the above scan normal or abnormal?
Answer
Grossly abnormal. Specific tracer binding is markedly reduced in the caudate and putamen bilaterally, the typical "two full stops" appearance. Patients with symptoms on one side of the body often have bilateral abnormality on imaging.
Return to Nuclear Medicine Case-Based Learning
The text is entirely the opinion of the author and does not necessarily reflect that of RUH NHS Trust or the Bristol Radiology Training Scheme. Website content devised by Paul McCoubrie.