多巴胺转运体SPECT显像评估帕金森病严重程度的研究

^(99m)Tc-TRODAR-1 SPECT imaging of dopamine transporter in assessing the degree about the severity of Parkinson disease

目的本研究探讨显像评估帕金森病严重程度的意义。方法对15例对照者和30例帕金森病患者(根据Hoehn-Yahr分级分为早期组18例,中晚期组12例)行99mTc-TRODAT-1DATSPECT断层显像,注射示踪剂2~3h后采集图像,勾画出感兴趣区(双侧纹状体和枕叶),计算机自动计算感兴趣区的放射性计数,最后测算出纹状体与枕叶部位的放射性计数比值和非对称性指数,并进行比较分析。结果对照组特异性放射性计数比值是0.58±0.16(左侧)、0.56±0.32(右侧),早期帕金森病组特异性放射性计数比值为0.40±0.33(症状对侧或症状严重肢体对侧)、0.51±0.12(症状同侧),中晚期帕金森病组特异性放射性计数比值为0.23±0.18(症状严重肢体对侧)、0.40±0.17(症状同侧);对照组非对称性指数是5.12±0.48,早期帕金森病组为9.05±14.61,中晚期组为20.67±14.2,3组间比较均有显著性差异(P<0.05)。结论多巴胺转运体99mTc-TRODAT-1SPECT显像有助于帕金森病严重程度的判断。

Objective The imaging of dopamine transporter (DAT) with 99m Tc-TRODAT-1 and SPECT has been recently proposed to be a valuable and feasible means of the integrity and function of dopamine neurons.The purpose of this study was to investigate the value of DAT SPECT imaging for assessing the degree of the severity of Parkinson disease.Methods SPECT imaging with 99m Tc-TRODAT-1 was conducted in 30 patients and 15 heathy subjects.Those with Parkinson disease were conducted of Hoehn-Yahr classification at first,and be subdivided into two groups:early stage Parkinson disease group and mid-late Parkinson disease group.The images were obtained 2～3 h after the intravenous injection of the tracer.The regions of intresting including bilateral striatum (ST) and occiptal lobe (OC) were figured,and radioactivity counts of three regions were got by computer automatically.At last the ratio of specific radioactivity uptake and asymmetry indexes of the three groups were calculated and compared.Results The ratios of specific radioactivity uptake in healthy groups were 0.58 ± 0.16 (left)、 0.56 ± 0.32 (right),The ratios of specific radioactivity uptake were 0.40 ± 0.33 (side contralateral to onset or more severe limb)、 0.51 ± 0.12 (ipsilateral side) in early Parkinson disease group, 0.23 ± 0.18 (side contralateral to more severe limb) and 0.40 ± 0.17 (ipsilateral side) in mid-late Parkinson disease group.Asymmetry index was 5.12 ± 0.48 in healthy group, 9.05 ± 14.61 in early Parkinson group and 20.67 ± 14.20 in mid-late Parkinson group.The difference of the ratios of specific ratioactivity uptake and asymmetry index among three groups were significant ( P < 0.05 ).Conclusions The dopamine transporter SPECT imaging with 99m Tc-TRODAT-1 can help us to assess the degree about the severity of Parkinson disease.