^(99)Tc^m-TRODAT-1 SPECT脑多巴胺转运体显像在帕金森病和原发性震颤中的应用研究

The clinical application study of ^(99)Tc^m-TRODAT-1 SPECT DAT Imaging on Parkinson Disease and Essential Tremor

目的探讨99Tcm-TRODAT-1 SPECT脑多巴胺转运体(DAT)显像在帕金森病(PD)和原发性震颤(ET)中的应用价值。方法对经我院确诊的51例PD患者,19例确诊为ET患者及11例正常人进行99Tcm-TRODAT-1 SPECT脑DAT显像。利用感兴趣区技术(ROI)计算PD患者、ET患者和正常人DAT对99Tcm-TRODAT-1的特异性摄取比值及两侧特异性放射性摄取比值的不对称指数(AIPD、AICON)。结果 1)正常对照组左右侧脑多巴胺转运体的特异性放射性摄取比值分别为1.633±0.088、1.623±0.0691,双侧对称,双侧比较无统计学意义(t=0.655,P=0.527),不对称指数为2.074±1.793。正常人双侧ST/CB均值的95%可信区间为1.577-1.678。2)ET患者左右侧脑多巴胺转运体的特异性放射性摄取比值分别为1.561±0.117、1.546±0.115,两侧基本对称,双侧比较无统计学意义(t=1.396,P=0.180),双侧ST/CB均值及不对称指数同正常人比较无统计学意义(t=1.934,P=0.063;t=-0.795,P=0.433)。ET患者双侧ST/CB均值的95%的可信区间为1.498-1.608。3)PD患者双侧ST/CB比值低于正常人ST/CB比值,具有统计学意义(t=-3.625,P=0.001,t=-4.968,P=0.000)。PD患者左右双侧ST/CB值的95%的可信区间分别为1.386-1.463、1.447-1.534。结论99Tcm-TRODAT-1 SPECT脑多巴胺转运体显像可鉴别帕金森病与原发性震颤,弥补CT、MRI等检查的不足,为临床治疗提供重要信息。

[ Objective ] To research the application value of ^（99）Tc^m-TRODAT-1 SPECT imaging of dopamine transporter in the differention between Parkinson disease（PD） and Essential Tremor（ET）. [ Methods ] 5 1 patients with Parkinson disease,19 patients with essential tremor（ET） and a contrastive group of 11 healthy subjects were studied with ^（99）Tc^m-TRODAT-1 DAT SPECT imaging.The radioactive ratio between bilateral striatum and cerebellum（ST/CB） and the asymmetry index （AI）of bilateral striatum were computed by using region of interest （ROI） technology and compared.The specific radioactivity uptake was measured in bilateral striatum and cerebellum. [ Resluts ] 1）The specific radioactivity uptake ratios ofdopamine transporters of the bilateral striatum in the contrastive group of 14 healthy subjects are 1.633 ± 0.088 for the left side and 1.623 ± 0.069 for the right side, with the two sides remaining almost symmetrical and without any statisticalsignificance （t=0.655, P=0.527）.And the AI was 2.074 ± 1.793.And 95% confidence interval of ST/CB was 1.577-1.678.2） The specific radioactivity uptake ratios of dopamine transporters of the bilateral striatum in ET patients are 1.561 ± 0.117for the left side and 1.546 ± 0.115 for right side, with the two sides remaining symmetrical and without any statistical significance （t= 1.396, P=0.180）.There is no statistic significance for the bilateral ST/CB and AI between ET patients andhealthy subjects（t=1.934, P=0.063; t=-0.795, P=0.433）.And 95% confidence interval of ST/CB was 1.498-1.608.3） For the PD, both ST/CB were lower than those in the healthy subjects（t=-3.625, P=0.O01, t=-4.968, P〈0.000）.And 95%confidence interval of bilateral ST/CB were 1.386-1.463 anti 1.447-1.534 respectively. [ Conclusion ] ^（99）Tc^m-TRODAT-1 DAT SPECT imaging can be used to differentiate PD from essential tremor, and make up for the shortage of MRI, CT andso on, so it can provide important information.