^(99)Tc^(m)-MIBI SPECT/CT显像在原发性颈部肌张力障碍中的应用  

Application of ^(99)Tc^(m)-MIBI SPECT/CT imaging in patients with primary cervical dystonia

作　　者：李红磊[1] 王丽 金超岭 段晓慧[3] 董明睿[3] 刘晓建[1] 郑玉民[1] Li Honglei;Wang Li;Jin Chaoling;Duan Xiaohui;Dong Mingrui;Liu Xiaojian;Zheng Yumin(Nuclear Medicine Department,China-Japan Friendship Hospital,Beijing 100029,China;Department of Neurology,the First Hospital of Tsinghua University,Beijing 100016,China;Department of Neurology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院核医学科,北京100029 [2]清华大学第一附属医院神经内科,北京100016 [3]中日友好医院神经内科,北京100029

出　　处：《中华核医学与分子影像杂志》2023年第5期277-280,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：中日友好医院横向课题(2021-HX-83)。

摘　　要：目的探索^(99)Tc^(m)-甲氧基异丁基异腈(MIBI)SPECT/CT显像在寻找和定位原发性颈部肌张力障碍(PCD)患者主要痉挛肌肉中的价值。方法前瞻性纳入2019年8月至2021年10月中日友好医院确诊的10例PCD患者[病例组;男3例、女7例, 年龄(47.3±9.9)岁]和10名健康志愿者[对照组;男4名、女6名, 年龄(43.5±9.4)岁], 行^(99)Tc^(m)-MIBI SPECT/CT颈部肌肉显像。测量对照组双侧头后大直肌、头下斜肌、头夹肌、半棘肌、胸锁乳突肌、斜方肌、斜角肌、肩胛提肌8对颈部肌肉SUVmax;确定病例组显像剂异常摄取肌肉, 勾画ROI, 测量SUVmax。采用两独立样本t检验比较病例组与对照组间肌肉摄取差异, 采用χ^(2)检验分析病例组颈部MRI与SPECT/CT显像对异常肌肉的检出差异。结果 SPECT/CT显像示正常颈部肌肉呈对称性、轻度显像剂摄取(SUVmax:1.10±0.19)。共发现病例组10例患者异常显像剂摄取肌肉60块, 检出率为37.50%(60/160), 其中头后大直肌7块、头下斜肌10块、头夹肌8块、半棘肌8块、胸锁乳突肌10块、斜方肌5块、斜角肌3块、肩胛提肌9块, 较正常肌肉摄取明显增高(SUVmax:1.81±0.43;t=17.05, P<0.001)。颈部MRI仅发现异常肥大肌肉30块, 检出率(18.75%, 30/160)明显低于SPECT/CT显像(χ^(2)=28.03, P<0.001)。结论 ^(99)Tc^(m)-MIBI SPECT/CT显像可直观显示主要痉挛肌肉, 可能成为指导临床精准注射治疗颈部肌张力障碍的有效检查方法。Objective To evaluate the value of ^(99)Tc^(m)-methoxyisobutylisonitrile(MIBI)SPECT/CT imaging for the identification of dystonic muscles in patients with primary cervical dystonia(PCD).Methods A total of 10 patients with PCD(3 males,7 females,age(47.3±9.9)years)and 10 healthy subjects(4 males,6 females,age(43.5±9.4)years;control group)between August 2019 and October 2021 in China-Japan Friendship Hospital were enrolled prospectively.All subjects underwent ^(99)Tc^(m)-MIBI SPECT/CT scan.The SUVmax of 8 bilateral representative muscles,including rectus capitis posterior major,obliquus capitis inferior,splenius capitis,semispinalis,sternocleidomastoid,trapezius,musculus scalenus muscle and levator scapulae were evaluated in control group.In PCD group,muscles with abnormal uptake were determined.ROI was drawn and SUVmax was measured.Independent-sample t test was used to analyze the differences of SUVmax between normal and abnormal muscles.The detecting rates of neck MRI and SPECT/CT for abnormal muscles were analyzed byχ^(2) test.Results Normal muscles of healthy subjects showed mild symmetrical radioactivity distribution,with the SUVmax of 1.10±0.19.A total of 60 muscles with abnormal uptake in 10 patients were found,including 7 rectus capitis posterior major,10 obliquus capitis inferior,8 splenius capitis,8 semispinalis,10 sternocleidomastoid,5 trapezius,3 musculus scalenus muscle and 9 levator scapulae.The SUVmax of muscles with abnormal uptake was 1.81±0.43,which was higher than that of normal muscles(t=17.05,P<0.001).Only 30 pieces abnormal hypertrophy muscle were found by neck MRI,and the detecting rate was much lower than that of SPECT/CT(18.75%(30/160)vs 37.50%(60/160);χ^(2)=28.03,P<0.001).Conclusion ^(99)Tc^(m)-MIBI SPECT/CT may be a useful method for identifying dystonic muscles and a guide to precision therapy in patients with PCD.

关 键 词：斜颈 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 99M锝甲氧基异丁基异腈 

分 类 号：R685[医药卫生—骨科学]