| 董峰,刘晓华,谭建,张本恕,孙峰.99Tcm-TRODAT-1脑显像在帕金森病诊断与分级中的应用[J].中国医学影像技术,2006,22(7):1079~1082 |
| 99Tcm-TRODAT-1脑显像在帕金森病诊断与分级中的应用 |
| 99Tcm-TRODAT-1 SPECT imaging for diagnosis and scaling of Parkinson's disease |
| 投稿时间：2006-02-07 修订日期：2006-03-23 |
| DOI： |
| 中文关键词: TRODAT-1 帕金森病 体层摄影术, 发射型计算机,单光子 多巴胺转运蛋白 |
| 英文关键词:TRODAT-1 Parkinson disease Tomography, emission-computed, single-photon Dopamine transporter |
| 基金项目: |
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| 中文摘要: |
| 目的 应用99Tcm-TRODAT-1对不同UPDRS分级的帕金森病(PD)患者进行多巴胺转运蛋白SPECT脑显像,探讨其在PD诊断与分级中的应用价值。方法 对不同分级(Hoehn & YahrⅠ~Ⅳ级,UPDRS评分9~108分)PD患者58例和对照组13例进行99Tcm-TRODAT-1 SPECT/CT脑断层融合显像。应用计算机感兴趣区(ROI)技术分别计算双侧纹状体/小脑、尾核/小脑、壳核/小脑的放射性计数比值,比较健康对照组及不同分级PD患者纹状体及其主要区域DAT功能差异,并对发病肢体对侧与同侧DAT功能进行比较,研究纹状体/小脑放射性计数比值与UPDRS评分之间相关性。结果 与健康对照组比较,Ⅰ~Ⅳ级PD患者纹状体DAT功能均明显减低,与UPDRS评分呈负相关;Ⅰ级~2.5级PD患者均以发病肢体对侧减低更为明显;Ⅲ、Ⅳ级两组患者间纹状体DAT功能及其同侧、对侧DAT功能无明显差异。Ⅰ级~2.5级PD患者尾核、壳核功能均较健康对照组减低且存在差异,以壳核减低更为明显;Ⅲ、Ⅳ级患者尾核、壳核DAT功能虽都明显减低但二者间无显著性差异。结论 99Tcm-TRODAT-1 SPECT脑显像可用于PD的早期诊断及病程分期,纹状体/小脑放射性计数比值可作为PD诊断及检测病情轻重的半定量分析指标,是H-Y分级与UPDRS评分的有益补充。 |
| 英文摘要: |
| Objective To investigate the clinical application value in the diagnosis and scaling of Parkinson's disease (PD) with 99Tcm-TRODAT-1 SPECT dopamine transporter (DAT) imaging. Methods Fifty-eight PD patients (Hoehn & Yahr scale Ⅰ-Ⅳ, UPDRS score 9-108) and 13 volunteers were recruited. The radiation ratios of striatum and its subregions, including the putamen and caudate nucleus, over the cerebellum were calculated by semi-quantity region of interest(ROI) technique. The function differentiation of striatum and putamen or caudate nucleus, between the healthy volunteers and different scaled PD patients were compared, the DAT value between contralateral and ipsilateral to symptoms or more affected limbs was compared as well. The relationship between the radiation ratios of striatum/cerebellum and UPDRS score was analyzed. Results The DAT level of PD patients scaled Ⅰ-Ⅳ was more lower than that of the healthy volunteers. There exited negative correlation between the radiation ratio and the UPDRS score; the DAT levels of striatum contralateral to the affected limb were lower than those of ipsilateral of PD patients scaled Ⅰ-2.5. For patients scaled Ⅲ-Ⅳ, neither difference was seen between the two sides, nor difference between the two scales. For patients scaled Ⅰ-2.5, the DAT function of putamen and caudate nucleus were both lower than that of healthy volunteers, there also exited difference between putamen and caudate nucleus, more loss of DAT function was seen in the putamen nucleus. For patients scaled Ⅲ-Ⅳ, both putamen and caudate nucleus function decreased obviously, while no difference between the two nucleus. Conclusion 99Tcm-TRODAT-1 SPECT brain imaging is helpful for the early diagnosis and scaling of PD. The radiation ratio of striatum/cerebellum can be used as a semi-quantitative standard for the diagnosis and severity evaluation of PD, it is also a valuable complement to the monitoring of PD in addition to Hoehn & Yahr scale and UPDRS score. |
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