早期帕金森病患者脑^(99)Tc^m-TRODAT-1 SPECT显像研究

Study of ^(99)Tc^m-TRODAT-1 SPECT DAT SPECT imaging on human brain with early stage Parkinson's disease

目的 探讨脑多巴胺转运蛋白 (DAT) 99Tcm 2 β [N ,N′ 双 (2 巯乙基 )乙撑二胺基 ]甲基 ,3 β (4 氯苯基 )托烷 (TRODAT 1)SPECT显像在帕金森病 (PD)早期诊断中的临床应用价值。 方法 对10例正常对照者及 50例早期PD患者行脑DAT99Tcm TRODAT 1SPECT显像 ,利用感兴趣区技术计算纹状体 (ST)与枕叶 (OC)、额叶 (FC)的放射性比值 [(ST -OC) OC ,(ST -FC) FC]。结果 对照组双侧ST摄取差异无显著性。早期PD患者双侧 (ST -OC) OC和 (ST -FC) FC较对照组明显降低 ;起病肢体对侧 (ST -OC) OC和 (ST -FC) FC比起病肢体同侧均明显降低 (P均 <0 0 0 1)。PDHoehn Yahr(H Y)Ⅰ级患者病变肢体对侧及同侧 (ST -FC) FC较对照组均明显降低 (P均 <0 0 5)。早期PD患者起病肢体对侧ST摄取与病程及H Y分级呈明显相关。结论 脑99Tcm TRODAT

Objective To evaluate the clinical application values of 99 Tc m-2β- [ N , N′ -bis(2-mercaptoethyl) ethylenediamino] methyl, 3β-(4-chlorophenyl) tropane (TRODAT-1) dopamine transporter (DAT) SPECT imaging in the diagnosing of early stage Parkinson's disease(PD). Methods Ten healthy controls and fifty patients with early-stage PD were examined with 99 Tc m-TRODAT-1 DAT SPECT imaging.Striatal specific up ta ke of 99 Tc m-TRODAT-1 was calculated with region of interest an alysis according to the ratios between striatum and occipital cortex [(ST-OC)/O C] and between striatum and frontal cortex [(ST-FC)/FC]. Results No obvious side-to-side differences were observed in controls. There was a significant decline in bilateral (ST-OC)/OC and (ST-FC)/FC in early stage PD c ompared to controls. (ST-OC)/OC and (ST-FC)/FC in the striatum contralateral to the predominantly affected limbs decreased significantly compared to ipsilater al side ( P <0.001). (ST-FC)/FC in striatum contralateral and ipsilateral to the clinical symptom in Hoehn-Yahr (H-Y) Ⅰstage patients decreased significa ntly compared t o controls ( P <0.05). Striatal uptake contralateral to the clinical symptom had significant correlation with the duration and H-Y stage of PD. Concl usion DAT 99 Tc m-TRODAT-1 SPECT imaging on human brain w ill help to the diagnosing of early stage PD.