^(99m)Tc-TRODAT-1脑SPECT显像对帕金森病的早期诊断价值  

Clinical value of ^(99m)Tc-TRODAT-1 SPECT dopamine transporter Imaging in Early Diagnosis of Parkinson′s Disease

作　　者：林志坚[1] 张海鸥[1] 吴军[1] 高宙[2] 

机构地区：[1]北京大学深圳医院神经内科,广东深圳518036 [2]北京大学深圳医院核医学科,广东深圳518036

出　　处：《中国误诊学杂志》2007年第11期2437-2439,共3页Chinese Journal of Misdiagnostics

摘　　要：目的:评价脑99Tcm-2β[N,N′-双(2-巯乙基)乙撑二胺基]甲基,3β-(4-氯苯基)托烷(99mTc-TRODAT-1)SPECT多巴胺转运蛋白(dopamine transporter,DAT)显像对帕金森病(Parkinson′s disease,PD)早期诊断的临床应用价值。方法:对21例早期PD患者(Hoehn-Yahr 1级12例,2级9例)及15例健康对照者分别进行99mTc-TRODAT-1SPECT脑显像,剂量为740 MBq。应用计算机感兴趣区技术及2个数学模型分别计算早期PD患者及健康对照者双侧纹状体体积(V,cm3)、质量(W,g),代表相应部位的多巴胺转运蛋白功能水平。结果:健康对照组SPECT扫描示DAT核素密度集中于双侧纹状体呈红色,左右基本对称,双侧纹状体貌似“熊猫眼”。早期PD患者双侧纹状体DAT核素分布不均匀,形状各异,其体积和质量均低于健康对照者,差异有显著性(P<0.01);早期PD患者症状对侧纹状体体积和质量均显著低于症状同侧(P<0.01);Hoehn-Yahr 2级PD患者双侧纹状体DAT体积和质量均低于Hoehn-Yahr 1级PD患者,差异有显著性(P<0.05)。结论:DAT数量减少是PD发病的重要环节之一,99mTc-TRODAT-1脑SPECT显像有助于PD的早期临床诊断。Objective：To evaluate the clinical application values in the diagnosis of early-stage Parkinson＇s disease （PD） with ^99mTc-TRODAT-1 SPECT dopamine transporter （DAT） imaging. Methods：Twenty-one patients with earlystage idiopathic PD and fifteen age-matched healthy volunteers were recruited. Twelve patients were stage 1 and nine patients were stage 2 as assessed by Hoehn-Yahr scale. Brain SPECT imaging was performed at 2.5 hours after intra- venous injection of ^99mTc-TRODAT-1 25mCi. Using region of interest （ROI）technique and two mathematical models to work out the striatum V（cm^3） and W（g） respectively. Results ：In the healthy control group ,the nuclear density of DAT concentrated at bilateral striatum,like ＂panda eyes＂. In the early-stage PD group, DAT imaging showed that the shape of bilateral striatum was asymmetrical ,the striatum V and W of both side of striatum were lower than those of healthy volunteers（P〈0.01）. In the early PD patients ,the striatum V and W were significantly lower in contralateral than in ipsilateral striatum to the clinically symptomatic side（P（0.01）. The striatum V and W of bilateral striatum in stage 2 group were significantly lower than those in stage 2 group （P〈0.05）. Conclusion：The decrease of DAT is one of the pathogenic of PD. ^99mTc-TRODAT-1 SPECT imaging is a useful method for early diagnosis of PD in clinical practice.

关 键 词：帕金森病/诊断 膜转运蛋白质类/代谢 托烷类/诊断应用 有机锝化合物/诊断应用 体层摄影术 发射型计算机 单光子 

分 类 号：R742.504[医药卫生—神经病学与精神病学]