^(99m)Tc-TRODAT-1单光子放射计算机断层显像早期诊断帕金森病的研究

Study on ^(99m)Tc-TRODAT-1 SPECT in diagnosis of early Parkinson's disease

目的 探讨99mTc TRODAT 1单光子放射计算机断层显像 (SPECT)早期诊断帕金森病 (PD)的价值。方法 分别对PD组和正常对照组进行99mTc TRODAT 1SPECT脑显像 ,使用SiemensECAMSPECT双探头。从横断面上选出基底节最清晰的一层进行相对定量分析 ,应用计算机感兴趣区 (ROI)技术在图像上分别勾划基底节 (BG)和枕叶 (OC)ROI,计算BG/OC放射性比值。结果 PD组 2 2例 ,按改良Hoehn和Yahn评分 :1级组 8例 ,1.5级组 14例 ;对照组 6例。99mTc TRODAT 1SPECT脑显像示 ,PD患者症状对侧BG受损情况明显重于症状同侧BG ,与正常对照组比较有明显的差异。BG/OC比值显示 :1级和 1.5级PD患者的症状对侧BG/OC比值均显著低于症状同侧 (P <0 .0 1) ;1.5级PD患者两侧BG/OC平均值 (1.2 0± 0 .17)与对照组 (1.5 5± 0 .12 )比较 ,差异有显著性 (P <0 .0 0 1) ;1级PD患者症状对侧BG/OC(1.34± 0 .13)与 1.5级 (1.17± 0 .16 )比较 ,差异有显著性 (P <0 .0 5 ) ;1级PD患者两侧BG/OC平均值 (1.4 0± 0 .15 )与对照组 (1.5 5± 0 .12 )比较 ,差异无显著性 (P >0 .0 5 ) ;1级与 1.5级PD患者的BG/OC平均值之间差异有显著性 (P <0 .0 5 )。正常对照组BG/OC比值显著高于PD组 (1级和 1.5级 ) (P <0 .0 0 1)。1级与 1.5级PD患者症状同侧的BG/

Objective To assess the value of 99m Tc TRODAT 1 SPECT in diagnosis of early Parkinson's disease(PD). Methods Twenty two patients of early idiopathic PD were studied with 99m Tc TRODAT 1 SPECT. For all patients, the PD was stage 1.5 or less as assessed by the new Hoehn and Yahr scale. Six age matched healthy volunteers (4 men, 2 women) served as controls. 99m Tc TRODAT 1 was prepared from a lyophilized kit. Brain imaging was performed on a dual head camera between 2 ～ 4 h after injection of 1 110 MBq (30mCi) 99m Tc TRODAT 1. Mean counts per pixel were measured manually in the region below the basal ganglia (BG) and normalized to the mean background counts to give specific uptake values (BG/OC). Logistic discriminant analyses were performed to determine the optimum uptake value for differentiating the patients from the controls. Results Quantitative imaging analysis showed that in the Hoehn and Yahn 1 PD and 1.5 PD groups mean the BG/OC (1.40±0.15, 1.20±0.17 respectively)value were less than those in the controls (1.55±0.12) ( P <0.01, P <0.001 respectively). The mean values of specific BG uptake contralateral to the more affected limbs were significantly decreased compared with the ipsilateral sides in both stage 1 and 1.5 groups (1.34±0.13 vs 1.45±0.18, P <0.01, for stage 1 and 1.17±0.16 vs 1.23±0.18, P <0.01, for stage 1.5). No remarkable adverse reactions were found either in the patients or the controls during or after imaging. Conclusion 99m Tc TRODAT 1 SPECT and basal ganglia uptake may serve as a useful imaging method for early detection of Parkinson's disease.