^99mTc-TRODAT-1 SPECT多巴胺转运体显像在诊断早期帕金森病中的意义

目的探讨99mTc-TRODAT-1 SPECT多巴胺转运体(DAT)显像在诊断早期帕金森病(PD)中的意义.方法对62例早期PD、12例晚期PD及10名正常人进行99mTc-TRODAT-1 SPECT 基底节DAT显像,选取纹状体区和小脑为感兴趣区,计算两者的放射性比值,比较3组间该比值的差异,并分析早期PD患者DAT放射性结合率与H&Y分级及UPDRS评分之间的相关性.结果PD患者基底节99m Tc-TRODAT-1摄取率显著降低,早期PD患者病变较重肢体对侧纹状体放射性摄取率较同侧纹状体显著下降.PD患者纹状体区放射性摄取率与PD患者的H&Y分级呈负相关,而与UPDRS Ⅱ、Ⅲ评分无相关性.结论99mTc-TRODAT-1 SPECT基底节 DAT显像可用于临床早期PD的诊断.

Evaluation of Early-stage Parkinson's Disease with 99m Tc-TRODAT-1 SPECT DAT Imaging

Aim: To investigate the potential usefulness of 99mTc-TRODAT-1 imaging in the evaluation of patients with early-stage Parkinson's disease and correlate the findings to the severity of the disease. Methods: 62 patients with early-stage idiopathic Parkinson's disease were recruited (for all patients, the Parkinson's disease was stage 2 or less as assessed by the Hoehn and Yahr scale), 12 advanced Parkinson patients ( stage 4 by the Hoehn and Yahr scale ), 10 patients with parkinsonism, 19 patients with essential tremor, and 10 age-matched healthy volunteers served as controls. Brain SPECT imaging was performed 2 hours after injection of 99mTc-TRODAT-1 . Regions of interest were drawn over the striatum and the cerebellum, and the ratios of striatum-to-cerebellum ( ST/CB) were calculated. The correlations among DAT binding in striatum and Hoehn and Yahr scale and UPDRS motor scores were determined in the parkinsonian patients. Results: A reduction of specific striatal uptake of 99mTc-TRODAT-l was found in Parkinson's disease patients. The mean values of specific uptake contralateral to the more affected limbs were significantly decreased compared with the ipsilateral sides in patients with early stage Parkinson' s disease. The DAT binding uptake in striatum of all parkinsonian patients showed significantly negative correlation to H&Y stage, but did not show any relation to UPDRS motor scores. Conclusion: For clinical practice, 99m Tc-TRODAT-1 DAT SPECT imaging is helpful for the early detection of Parkinson's disease.