^(99m)Tc-TRODAT-1脑半定量分析鉴别帕金森氏病与血管帕金森样征的研究

Differential Diagnosis of Parkinson's Disease and Vascular Parkisonism With ^(99m)Tc-TRODAT-1 Semiquantitative Analysis

目的应用99mTc-TRODAT-1脑SPECT半定量分析鉴别血管性帕金森样征与帕金森氏病。方法11例VP病人、26例PD病人、12例健康志愿者接受740MBq(20mCi)99mTc-TRODAT-1静脉注射3~4h后,作脑SPECT显像和半定量分析。通过计算机处理获得纹状体99mTc-TRODAT-1特异结合比率,即S/O摄取比值。结果通过对VP病人、PD病人和健康志愿者脑SPECT感兴趣区半定量分析,S/O比值在VP病人略低于健康对照者但无明显统计学差异;在PD病人,S/O比值则明显下降(P<0.01)。PD病人双侧纹状体摄取99mTc-TRODAT-1明显不对称,VP病人无此现象(P<0.05);VP病人组与健康志愿组S/O摄取比值随年龄增长而下降(P<0.05);PD病人组则无此现象。结论99mTc-TRODAT-1脑SPECT半定量分析是一种帕金森氏病早期诊断、用于鉴别VP和PD的可靠而实用的方法。

Objective To differentiate vascular parkisonism （VP） from Parkison＇ s disease （PD） with ^99mTc-TRODAT-1 brain SPECT semiquantitative analysis. Methods 11 VP patients, 26 PD patients and 12 healthy （control） individuals were studied. A 740 MBq （20mCi） dose of ^99mTc-TRODAT-1 was injected intravenously. After 3 - 4 hr brain SPECT imaging and semiquantitative analysis were acquired. The ratio of specific striatal ^99mTc-TRODAT-1 binding was calculated by dividing the specific striatal uptake by the occipital binding. Results After a ROI semiquantitative analysis of SPECT imaging from Vp patients, PD patients and healthy controls were performed to abtain ratio striatal uptake to occipital binding, the specific binding in the VP patients was slightly lower than but not statistically different from that of the healthy controls in striatal areas. A significant decrease in striatal uptake of ^99mTc-TRODAT-1（P〈0.01） was found in PD patients. There was significant bilateral striatal asymmetry in PD patients but not in VP patients （P〈 0.01）. An age - related reduction of the S/O ratios was observed in both the VP patients and the healthy controls （ P 〈 0.05 ） but not in the PD patients. Conclusion ^99mTc-TRODAT-1 brain semiquantitative analysis is a reliable method to giagnosis Parkinson＇ s disease early and to differentiate VP from Parkison＇ s disease.Semiquantitative analysis