早期帕金森病^(99)Tc^m-TRODAT-1多巴胺转运蛋白SPECT脑显像  

SPECT Dopamine Transporter Imaging of Early-Stage Parkinson's Disease with^(99)Tc^m-TRODAT-1

作　　者：边艳珠[1] 冯珏[2] 刘怀军[1] 田瑞振[3] 哈志远[3] 李金福[2] 田国章[2] 

机构地区：[1]河北医科大学第二医院放射科,河北石家庄050051 [2]河北省人民医院核医学科 [3]河北省人民医院老年神经科

出　　处：《中国医学影像技术》2002年第8期746-748,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　应用99Tcm TRODAT 1进行多巴胺转运蛋白 (DAT)SPECT脑显像 ,探讨其在早期诊断帕金森病中的应用价值。方法　对Hoehn Yahr分级为Ⅰ级的 7例偏侧帕金森病患者和 7例年龄匹配的健康志愿者进行99Tcm TRODAT 1SPECT脑显像。应用计算机感兴趣区 (ROI)技术半定量计算纹状体 /小脑、尾核 /小脑和壳核 /小脑放射性计数比值 ,分别代表纹状体、尾核和壳核的DAT功能水平 ,对帕金森病患者纹状体及其组成部分的DAT功能与健康志愿者的相应区域DAT功能进行比较 ,并对帕金森病患者患侧肢体对侧和同侧纹状体、尾核和壳核的DAT功能分别进行比较。结果　早期帕金森病患者双侧纹状体DAT功能均低于健康志愿者 (1.5 5± 0 .16,1.46± 0 .14 ,1.80± 0 .0 4,P <0 .0 5 ,P <0 .0 1) ,并以患侧肢体对侧纹状体功能降低明显 (P <0 .0 1) ;与健康志愿者相比 ,双侧尾核DAT功能降低 (2 .2 0± 0 .0 5 ,1.88± 0 .3 8,1.62± 0 .2 2 ,P <0 .0 5 ,P <0 .0 0 1) ;与健康志愿者相比 ,双侧壳核DAT功能降低 (1.92± 0 .10 ,1.61± 0 .15 ,1.43± 0 .2 0 ,P <0 .0 1,P <0 .0 0 1) ,且以患侧肢体对侧壳核DAT功能降低明显 (P <0 .0 5 )。所有受检者在显像过程中及显像后均无不良反应发生。结论　99Tcm TRODATObjective To investigate the clinical application values in the diagnosis of early stage Parkinson's disease (PD) with 99 Tc m TRODAT 1 SPECT dopamine transporter (DAT) imaging. Methods Seven PD patients with early stage (Hoehn Yahr scale I) and seven age matched healthy volunteers were recruited. Brain SPECT imaging was performed at 180min after intravenous injection of 99 Tc m TRODAT 1 740MBq. The DAT levels of the striatum and its subregions,including the putamen and caudate nucleus,were calculated by semi quantity region of interest (ROI) technique with the radiation ratios of target/cerebellum. All the ratios of PD were compared with that of the two sides (ipsilateral and contralateral to the affected limb) and that of healthy volunteers. Results The DAT levels of both side striatum of PD patients were lower than those of healthy volunteers (1.55±0.16,1.46±0.14 vs 1.80±0.04, P <0.05, P <0.01). The DAT levels of striatum contral ateral to the affected limb were lower than those of ipsilateral of PD patients ( P <0.01). The DAT levels of both side caudate nucleus of PD patients were lower than those of healthy volunteers (1.88±0.38,1.62±0.22 vs 2.20±0.05, P <0.05, P < 0.001) . The DAT levels of both side putamen of PD patients were lower than those of healthy volunteers (1.61±0.15,1.43±0.20 vs 1.92±0.10, P <0.01, P <0.001). The DAT levels of putamen contralateral to the affected limb were lower than those of ipsilateral of PD patients ( P <0.05). No adverse reactions were found in either healthy volunteers or PD patients. Conclusion 99 Tc m TRODAT 1 SPECT imaging was a useful method of early diagnosis of PD in clinical practice.

关 键 词：SPECT脑显像 TRODAT-1 帕金森病 体层摄影术 发射型计算机 单光子 多巴胺转运蛋白 诊断 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]