^99Tc^m—TRODAT-1脑SPECT用于体质指数与纹状体多巴胺转运蛋白相互关系的研究

目的 探讨BMI与人脑纹状体DAT的相互关系及对99Tcm-TRODAT-1脑SPECT显像的影响.方法 31名健康志愿者（男16名,女15名）分别进行颅脑MRI和99Tcm-TRODAT-1脑SPECT显像.对SPECT图像进行三维重建,参照MRI图像,在SPECT图像横断面纹状体（ST）显示最清楚的连续4层图像上对脑左、右ST（LST、RST）分别进行ROI勾画,取小脑（CB）作为本底参考区,分别计算ST/CB、LST/CB和RST/CB的放射性摄取比值.采用SPSS 15.0软件,分别对ST/CB、LST/CB、RST/CB与BMI、年龄进行Pearson相关性分析;然后以BMI、年龄为自变量,ST/CB为因变量进行多因素回归分析.结果 31名健康志愿者99Tcm-TRODAT-1脑SPECT显像示双侧ST左右对称,放射性前部高于后部.其ST/CB、LST/CB和RST/CB的平均值分别为1.71±0.16,1.70±0.16和1.72±0.17;女性ST/CB、LST/CB和RST/CB的平均值分别为1.74±0.18,1.71±0.19和1.76±0.19;男性ST/CB、LST/CB和RST/CB的平均值分别为1.68±0.14,1.68±0.13和1.69±0.15.ST/CB、LST/CB和RST/CB与BMI均呈负相关（r=-0.53,-0.57,-0.47,P均＜0.05）.ST/CB与年龄呈负相关（r=-0.39,P=0.03）.多因素回归分析发现仅BMI为显著影响因素（回归系数β=-0.53,t=-3.36,P=0.002）.结论 健康人脑ST DAT水平随着BMI、年龄的增高而呈降低趋势.女性STDAT水平略高于男性.提示在99Tcm-TRODAT-1脑SPECT显像中,不但要考虑年龄、性别等影响因素,而且要注意BMI也是重要影响因素.     

抽动秽语综合征的脑99Tcm-TRODAT-1SPECT显像

Objective To observe dopamine transporter (DAT) binding capacity using 99Tcm-TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99Tcm-TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity.Methods Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99Tcm-TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results Compared with the control, higher symmetrically striatum uptake of 99Tcm-TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t =2.957, P＜0.05). Age (r= -0.320, P＞0.05)and tic severity(r = 0. 345, P ＞ 0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r = - 0. 483, P ＜ 0. 05). Conclusions 99 Tcm-TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS.     

帕金森病动物模型的^99Tc^m—TRODAT—显像研究

目的：研究帕金森病（PD）模型猴^99Tc^m-2β－[N,N‘-双（2－巯乙基）乙撑二胺基]甲基，3β－（4－氯苯基）托烷（TRODT－1）显像与局部脑血流量（rCBF）及结构改变间的关系，探讨^99Tc^m-TRODAT-1显像早期诊断PD的价值。方法：对5只猴在制成单侧PD模型前后分别进行^99Tc^m-TRODAT-1和rCBF显像，并对2只PD模型猴进行MRI。结果：^99Tc^m-TRODAT-1显像示，正常猴3h纹状体／小脑的放射性比值为1．48，PD模型猴健侧纹状体／小脑放射性比值为1．42，损毁侧为0．96。PD模型猴双侧纹状体血流灌注与正常猴比较无差别，MRI未发现形态及结构改变。结论：^99Tc^m-TRODAT-1能特异性地与多巴胺转运体（DAT）结合，可望用于PD的早期诊断。     

多巴胺转运蛋白显像剂^99Tc^m—TRODAT—1临床前药理研究

目的 研究多巴胺转运蛋白（DAT）显像剂^99Tc^m－2β-[N,N‘-双（2－巯乙基）乙撑二胺基]甲基,3β-（4-氯苯基）托烷（TRODAT－1）用于帕金森病（PD）早期诊断的价值。方法 制备^99Tc^m－TRODAT－1,用2β－羧甲基,3β-（4-碘苯基）托烷（β－CIT）阻断DAT后,观察大鼠脑内分布、兔血药清除动力学、异常毒性实验、正常及PD模型 的放射自显影图并对志愿者进行显像。结果 制备的^99Tc^m－TRODAT－1放化纯大于90％,室温下h稳定;用β－CIT阻断后大鼠纹状体的特异性摄取即纹状体与离放射性计数差除以小脑放射性计数为0.12（对照组为3.45）,表明β－CIT对^99Tc^m－TRODAT－1有明显的竞争抑制作用。血药清除动力学研究表明它的分布半衰期T1／2（α)=1.2min,消除半衰期T1／2（β）=368min。模型鼠的放射自显影结果表明纹状体的特异摄取随着给药（神经毒素）总量的增加而减少,并有良好的线性关系（r=-0.9792）。正常猴断层显像在3个断面上基底节均有明显高于周围组织的摄取,单侧PD模型猴显像示健侧纹状体与小脑的比值（1.56）明显高于损毁侧比值（0.94）。志愿者脑断层单侧PD模型猴显像示健侧纹状体与小脑的比值（1.56）明显高于损毁侧比值（0.94）。志愿者脑断层图像清晰,患侧纹状体对^99Tc^m－TRODAT－1摄取较正常侧减低,其显像结果分析与临床表现相吻合。结论 ^99Tc^m－TRODAT－1制备方便,体外稳定,毒性低,用于人非常安全;纹状体与小脑、大脑皮质的比值高,有利于获得清晰的图像。     

多巴胺转运体显像对帕金森病的临床诊断研究

目的：用多巴胺转运体（DAT）显像剂^99mTc-2β-[N，N’-双（2-巯乙基）乙撑二氨基]甲基，3β（4-氯苯基）托烷（^990mTc-TRODAT—1）显像鉴别帕金森病（PD）与血管性帕金森综合征（VP）。材料和方法：28例PD患者，病程4个月-5年，15例VP患者，病程1-3年，正常对照组19例，静脉注射^99mTc-TRODAT—1，3h后行SPECT显像，并计算纹状体／小脑放射性比值（ST／CB）。结果：与正常对照组比较，PD患者纹状体^99mTc-TRODAT—1积聚显著下降，尤以壳核更为明显。早期PD患者（H／Y：1）即可见两侧ST／CB有显著差异；而VP患者纹状体内^9mTc-TRODAT—1放射性浓聚程度与对照组相似，ST／CB也无明显差异。结论：^99mTc—TRODAT-1多巴胺转运体SPECT显像有助于PD的早期诊断及鉴别诊断。     

年龄因素对大鼠多巴胺转运蛋白影响的实验研究

多巴胺（DA）转运蛋白（DAT）是摄取DA,调控突触间隙DA水平,维系突触前DA合成和储存的关键因素。DAT对帕金森病（PD）的研究有重要价值。^99Tc^m-2β-[N,N′-双（2-巯乙基）乙撑二胺基]甲基-3β-（4-氯苯基）托烷（TRODAT-1）可与DAT特异性结合,是研究DA能神经元功能较好的手段。已有利用^125I-13-甲基-3D-（4-碘苯基）托烷-2β-羧酸盐（CIT）研究大鼠纹状体中DAT水平随年龄变化的报道。本研究采用^99Tc^m-TRODAT-1研究大鼠纹状体中DAT水平随年龄的变化,现报道如下。     

多巴胺转运蛋白显像剂

目的研究多巴胺转运蛋白(DAT)显像剂99Tcm-2β-[N,N'-双(2-巯乙基)乙撑二胺基]甲基,3β-(4-氯苯基)托烷(TRODAT-1)用于帕金森病(PD)早期诊断的价值。方法制备99Tcm-TRODAT-1,用2β-羧甲基,3β-(4-碘苯基)托烷(β-CIT)阻断DAT后,观察大鼠脑内分布、兔血药清除动力学、异常毒性实验、正常及PD模型鼠的放射自显影图并对志愿者进行显像。结果制备的99TcmM-TRODAT-1放化纯大于90％,室温下放置6h稳定;用β-CIT阻断后大鼠纹状体的特异性摄取即纹状体与小脑放射性计数差除以小脑放射性计数为0.12(对照组为3.45),表明β-CIT对99Tcm-TRODAT-1有明显的竞争抑制作用。血药清除动力学研究表明它的分布半衰期T1/2(α)=1.2min,消除半衰期T1/2(β)=368min。模型鼠的放射自显影结果表明纹状体的特异摄取随着给药(神经毒素)总量的增加而减少,并有良好的线性关系(r=-0.9792)。正常猴断层显像在3个断面上基底节均有明显高于周围组织的摄取,单侧PD模型猴显像示健侧纹状体与小脑的比值(1.56)明显高于损毁侧比值(O.94)。志愿者脑断层图像清晰,患侧纹状体对99Tcm-TRODAT-1摄取较正常侧减低,其显像结果分析与临床表现相吻合。结论99Tcm-TRODAT-1制备方便,体外稳定,毒性低,用于人非常安全;纹状体与小脑、大脑皮质的比值高,有利于获得清晰的图像。     

帕金森患者脑多巴胺转运体11C-CFT PET/CT显像特点的分析

目的 探讨帕金森病（PD）患者11C-2β-甲氧甲酰-3β-（4-氟苯基）托烷（CFT）脑多巴胺转运体（DAT）PET/CT显像的特点,分析其对PD的临床诊断价值。 方法 回顾性分析2018年8月至2021年2月于贵州医科大学附属医院行11C-CFT PET/CT脑显像且经临床确诊的41例原发性PD患者的临床资料和影像学资料,其中男性21例、女性20例,年龄34~81岁（57.6±12.2）岁。根据Hoehn-Yahr（H-Y）分级将PD患者分为早期PD组（19例）和晚期PD组（22例）。同时纳入与PD组患者年龄匹配的8名健康受检者作为正常对照组,其中男性4名、女性4名,年龄42~72（61.0±9.8）岁。通过勾画感兴趣区（ROI）得到双侧尾状核、壳核及小脑3个层面的11C-CFT摄取值,按相应公式计算双侧尾状核、壳核、新纹状体的11C-CFT摄取值和不对称指数、壳核与尾状核摄取值的比值。计量资料的比较采用两独立样本t检验;计数资料的比较采用卡方检验;采用Pearson相关性分析评价PD患者新纹状体及各亚区DAT分布与各临床指标之间的相关性。 结果 在11C-CFT PET/CT脑显像中,PD组双侧尾状核放射性分布呈稍降低但尚均匀,双侧壳核放射性分布呈不同程度的降低或稀疏缺损。其中,早期PD组患者双侧壳核放射性分布呈不对称性降低或缺损;晚期PD组患者双侧壳核放射性分布呈较对称性稀疏缺损。与正常对照组比较,PD组新纹状体11C-CFT摄取值减低,且差异有统计学意义（12.29±2.75 对 7.69±2.42,t=4.818,P<0.01）;PD组不对称指数增高,且在壳核中表现最显著,差异有统计学意义（0.06±0.08 对 0.14±0.09,t=2.184,P<0.05）;PD组壳核与尾状核摄取值的比值降低,且差异有统计学意义（1.13±0.13 对 0.74±0.21,t=4.929,P<0.01）。与早期PD组比较,晚期PD组在新纹状体的摄取值降低最明显,且差异有统计学意义（8.50±1.77 对 6.99±2.71,t=2.070,P<0.05）,晚期PD组在尾状核、壳核不对称指数之间的差异均有统计学意义（0.06±0.06 对 0.11±0.08、0.18±0.10 对 0.11±0.07,t=2.251、2.858,均P<0.05）。PD患者新纹状体11C-CFT摄取值与年龄、起病年龄、H-Y分级均呈负相关（r=?0.444、?0.514、?0.426,均P<0.01）,与壳核11C-CFT摄取不对称指数呈正相关（r=0.331,P<0.05）。PD患者尾状核11C-CFT摄取值与年龄、起病年龄、H-Y分级均呈负相关（r=?0.537、?0.581、?0.380,均P<0.05）,与壳核不对称指数呈正相关（r=0.410,P<0.01）;PD患者壳核11C-CFT摄取值与起病年龄、H-Y分级均呈负相关（r=?0.353、?0.453,均P<0.05）,与病程、壳核与尾状核摄取值的比值均呈正相关（r=0.322、0.396,均P<0.05）。 结论 PD患者DAT在11C-CFT PET/CT脑显像上主要表现为双侧尾状核及壳核的放射性分布降低,11C-CFT PET/CT脑DAT显像有助于PD的诊断及其严重程度的评估。     

^18F-FECNT的生物分布特性及小动物PET显像研究

目的探讨多巴胺转运蛋白（DAT）显像剂^18F-N-（2-氟乙基）-2β-甲酯基-3β-（4-氯苯基）去甲基托烷（FECNT）的体内生物分布特性,并进行小动物PET显像研究,以评价其临床应用潜力。方法自制^18F-FECNT注射液,进行正常小鼠脑内分布、DAT阻断实验、正常和单侧帕金森病（PD）模型大鼠小动物PET脑显像。结果正常ICR小鼠在给药后5,15,30,60,120,180min的进脑量分别达2．22,1．20,1．02,0．78,0．71,0．67百分注射剂量率（％ID）。给药后5～60min内,药物在纹状体（ST）部位浓聚,纹状体／小脑（ST／CB）比值在5,15,30,60min时分别为2．56,3．47,2．78,1．63。120min后ST的放射性浓度下降至与其他脑组织相近。脑内DAT经β-CFF阻断的小鼠,其ST未见放射性浓聚。正常大鼠小动物PFT显像图中ST显影清晰（ST／CB=2．18±0．16,n=3）,双侧对称;PD模型大鼠未损毁侧ST放射性浓聚（ST未损毁侧／CB=2．01±0．23,n=3）,而损毁侧ST放射性摄取不明显,与小脑相当（ST损毁侧／CB=1．04±0．05）。结论^18F-FECNT能透过无损的血脑屏障浓聚于ST,对DAT具有高亲和性与特异性,是一种有临床应用潜力的DAT显像剂。     

^99Tc^m-二亚乙基三胺五乙酸与^99Tc^m-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

目的通过对比^99Tc^m-二亚乙基三胺五乙酸（^99Tc^m-DTPA）与^99Tc^m-奥曲肽（^99Tc^m-OCT）眼眶显像,比较两种显像方法在评估甲状腺相关眼病（TAO）患者眼部炎性反应活动度中的临床价值。方法26例TAO患者依据临床活动度评分（CAS）标准分为炎性反应活动组16例、非炎性活动组10例,另有14名正常志愿者作为对照组。静脉注射^99Tc^m-DTPA 740 MBq,0．5h后行眼眶平面及体层显像,隔日同一患者静脉注射^99Tc^m-OCT740MBq,1-2h后行眼眶平面及体层显像。获取各组两种眼眶显像剂的摄取率。对两种显像方法获得的半定量指标UROCT和URDTPA进行配对t检验并分别与CAS评分进行Spearman相关性分析。结果两种显像剂的眼眶摄取率未见明显差异（t=0．075,P〉0．05）。两种显像剂的眼眶摄取率（UROCT、URDTPA）与患者CAS评分之间具有很好的相关性（^99Tc^m-DTPA：r=0．835,P〈0．001;^99Tc^m-OCT：r=0．912,P〈0．001）。结论^99Tc^m-DTPA与^99Tc^m-OCT的眼眶显像有较好的一致性,证明^99Tc^m-DTPA眼眶显像是一种可行的、并可能成为一种很有发展前景的评价TAO炎性反应活动度的新方法。     

Evaluation of Tourette’s syndrome by 99mTc-TRODAT-1 SPECT/CT imaging

Objective

Clinical evidence indicates that the Tourette’s syndrome (TS) is associated with hyperactivity of the dopaminergic system; however, imaging studies of dopamine transporter (DAT) in TS patients remain controversial. In this study, we aimed to study DAT binding capacities in a relatively larger sample of drug-naive patients with TS in comparison with controlled subjects by ^99mTc-TRODAT-1 SPECT/CT imaging. We also aimed to look for any possible correlations between DAT and age, disease duration or tic severity of TS, which have not been thoroughly investigated in previous studies. We tried to provide more evidence for the understanding of the physiopathological mechanism of TS from the molecular imaging perspective.

Methods

Eighteen drug-naive patients with TS and 8 age- and gender-matched healthy subjects were recruited. Severity of TS was measured with Yale Global Tic Severity Scale. Brain SPECT/CT was performed 2.5 h after injection of ^99mTc-TRODAT-1. Regions of interest were drawn on the striatum including its sub-regions of caudate and putamen. The cerebellum was used as the reference region. DAT uptake ratio was calculated by subtracting the mean counts per pixel in the cerebellum from the mean counts per pixel in the striatum, caudate or putamen and by dividing the result by the mean counts per pixel in the cerebellum. Comparisons of DAT uptake ratios between TS patients and controls, and comparisons in bilateral striatum and sub-regions in TS patients were carried out. Correlation analysis between DAT uptake ratios and clinical data were also conducted.

Results

TS patients showed significantly higher uptake of ^99mTc-TRODAT-1 in bilateral striatum in comparison with the controls. There was no group-specific preferential lateralization in striatal uptake. DAT uptake ratios were not correlated with age and tic severity scores, but significant negative correlation with disease duration was found.

Conclusions

High level of DAT was demonstrated in drug-naive TS patients compared with normal controls, and it was negatively correlated with TS duration. Therefore, with the extension of the disease duration, certain degree of adaptation might occur in TS patients to compensate for the DAT increase, which suggested that hyper-functional DAT might be involved in the early pathophysiological changes of TS.     

帕金森病动物模型的99Tcm-TRODAT-1显像研究

目的　研究帕金森病 (PD)模型猴99Tcm 2 β [N ,N’ 双 (2 巯乙基 )乙撑二胺基 ]甲基 ,3β (4 氯苯基 )托烷 (TRODAT 1)显像与局部脑血流量 (rCBF)及结构改变间的关系 ,探讨99Tcm TRODAT 1显像早期诊断PD的价值。方法　对 5只猴在制成单侧PD模型前后分别进行99Tcm TRODAT 1和rCBF显像 ,并对 2只PD模型猴进行MRI。结果　99Tcm TRODAT 1显像示 ,正常猴 3h纹状体 小脑的放射性比值为 1.48,PD模型猴健侧纹状体 小脑放射性比值为 1 42 ,损毁侧为 0 .96。PD模型猴双侧纹状体血流灌注与正常猴比较无差别 ,MRI未发现形态及结构改变。结论　99Tcm TRODAT 1能特异性地与多巴胺转运体 (DAT)结合 ,可望用于PD的早期诊断     

Evaluating dopamine transporter activity with 99mTc-TRODAT-1 SPECT in drug-naive Tourette's adults

OBJECTIVES: Findings on imaging of dopamine transporter (DAT) activity in patients with Tourette's syndrome remain inconclusive. The present study was carried out to observe DAT activity in patients with well-controlled Tourette's syndrome by using (99m)Tc-TRODAT-1 single photon emission computerized tomography (SPECT). METHODS: Six drug-naive patients with Tourette's syndrome (mean age+/-SD, 21.2+/-1.5 years) were recruited. All met the criteria for Tourette's syndrome established in the DSM-IV. Seventeen age-matched and sex-matched healthy subjects served as the controls. Brain SPECT were acquired 165-195 min after administrating 740 MBq of (99m)Tc-TRODAT-1, using a double-headed camera equipped with ultra-high-resolution fan-beam collimators. The specific uptake ratio was calculated by subtracting the mean counts per pixel in the occipital cortex from the mean counts per pixel in the striatum, putamen or caudate nucleus and by dividing the result by the mean counts per pixel in the occipital cortex. Tic-severity scores were also measured and correlated with the specific uptake ratios. RESULTS: No significant difference in DAT activity between patients with Tourette's syndrome and control subjects was found in the striatum and its sub-regions. Tic-severity scores were also not correlated with specific uptake ratios measured from the striatum and its sub-regions. CONCLUSIONS: In conjunction with previous findings, our results suggested that functional abnormality of the dopamine system in patients with Tourette's syndrome might be evident only in its early stage. Adaptation to tic symptoms might play a role in regulating the neural system.     

The clinical value of Tc-99m TRODAT-1 SPECT for evaluating disease severity in young patients with symptomatic and asymptomatic Wilson disease

PURPOSE: The purpose of this study was to determine the clinical value of applying Tc-99m TRODAT-1 single photon emission computed tomography (SPECT) of the dopamine transporter to evaluate disease severity in young patients with symptomatic or asymptomatic Wilson disease (WD). MATERIALS AND METHODS: The evaluation of Tc-99m TRODAT-1 SPECT was performed in 18 patients with symptomatic WD, 13 patients with asymptomatic WD, and, as controls, 12 normal volunteers matched for age and gender. The neurologic symptoms of symptomatic patients were evaluated by an experienced neurologist. The ratios of specific striatal Tc-99m TRODAT-1 binding [with the cerebellum (CB) as the reference region] were calculated as striatum (ST)/CB and compared among the 3 groups. Using correlation analysis, the ratios for the WD patients were compared with clinical data on the severity of neurologic symptoms. RESULTS: Significant differences of ST/CB ratios were found among the 3 groups (Sym vs. Nor, P = 0.000; Asym vs. Nor, P = 0.036; Sym vs. Asym, P = 0.011, respectively). In 23 patients (18 with symptomatic WD, 5 with asymptomatic WD), the posterior putamina showed more remarkable deformation and decreased radiotracer uptake. The ST/CB ratios correlated negatively with the severity of neurologic symptoms (r = -0.80, P < 0.01). CONCLUSIONS: The decreased striatal Tc-99m TRODAT-1 uptake found in young WD patients, including symptomatic WD and some asymptomatic WD, as detected with SPECT, seems to indicate presynaptic damage of the dopaminergic nerve terminals. The decrease in radiotracer uptake was more prominent in the posterior putamina than in the caudate heads. The Tc-99m TRODAT-1 SPECT method can be used effectively for evaluating disease severity in WD.     

复方磷酸可待因口服液依赖者多巴胺转运蛋白SPECT显像

目的 研究长期大剂量使用复方磷酸可待因口服液产生依赖对脑纹状体功能的损害.方法 29例复方磷酸可待因口服液依赖者、27例海洛因依赖者和31例健康志愿者分别行99Tcm-2β-[N,N＇-双（2-巯乙基）乙撑二胺基]甲基,3β-（4-氯苯基）托烷（TRODAT-1）SPECT显像,定性分析多巴胺转运蛋白（DAT）影像特征,同时定量分析3组受试者纹状体体积（V,cm3）、质量（m,g）和纹状体与全脑放射性比值（Ra,%）.使用SPSS 13.0软件对3组受试者的V、m和Ra进行t检验.结果 健康对照组双侧纹状体呈典型＂熊猫眼＂形态,DAT放射性分布均匀、对称;复方磷酸可待因口服液依赖者双侧纹状体外形变小,形态失常,放射性分布减低、缺损甚至紊乱,存在部分非特异性放射性分布;海洛因依赖者与其类似.复方磷酸可待因口服液依赖组双侧纹状体V=（23.68±4.94）cm3、m=（24.87±5.19）g、Ra=（5.01±0.88）%,均低于健康对照组的（35.39±4.42）cm3、（37.16±4.64）g和（7.93±0.86）%,t=-9.69,-9.69,-13.01,P均=0.000,高于海洛因依赖组的（18.87±4.66）cm3、（19.81±4.90）g和（4.26±1.02）%,t=3.74,3.74,2.96,P分别为0.000,0.000,0.005.结论 长期大剂量使用复方磷酸可待因口服液产生依赖可破坏纹状体功能,使纹状体部位DAT的分布、密度和活性减低,类似海洛因成瘾性脑病.     

帕金森病动物模型的~(99)Tc~m-TRODAT-1显像研究

目的　研究99Tcm TRODAT 1在正常猴及帕金森病 (PD)模型猴纹状体内的放射性分布 ,以探讨其早期诊断PD的价值。方法　分别对 2只正常猴、2只PD模型猴进行99Tcm TRODAT 1多巴胺转运蛋白 (DAT)显像 ,1只经 1 甲基 4苯基 1,2 ,3 ,6 四氢吡啶 (MPTP)预处理后行 7、11、18d连续显像 ;计算正常猴与PD模型猴纹状体与小脑放射性比值。结果　正常猴 3h纹状体与小脑的放射性比值为 1 5 6;PD模型猴损毁侧纹状体与小脑比值为 0 94 ,健侧为 1 5 2 ;MPTP预处理后 7d与正常猴比值相似 ,11d时下降 ,18d时明显降低 ,比值分别为 1 5 6、1 2 7、0 89。结论　99Tcm TRODAT 1能特异性地与DAT结合 ,可灵敏地反映PD模型猴DAT的摄取减少 ,对PD的早期诊断有一定的临床价值。     

特发性肺动脉高压^18F—FDG右室心肌SPECT显像研究

目的探讨^18F—FDG心肌代谢SPECT显像在评价特发性肺动脉高压（IPAH）血流动力学变化、药物疗效和预后等方面的应用价值。方法24例IPAH患者接受^18F-FDG心肌代谢SPECT显像,利用勾画ROI的方法得到右室与左室游离壁的^18F—FDG摄取比值（RV／LV-FOG）。所有患者在核素显像后3d内行右心导管检查,测得平均肺动脉压（mPAP）及肺血管阻力（PVR）;其中15例患者在药物治疗6个月后复查^18F-FDG心肌代谢SPECT显像,并在显像后3d内行第2次右心导管检查;17例患者应用化学发光免疫分析法及酶免疫分析法分别测得血浆氨基末端脑钠肽前体（NT-proBNP）与内皮素-1（ET-1）的含量。所有患者均进行不少于12个月的随访。采用线性回归法分析RV／LV-FDG与mPAP以及Rv／LV—FDG与PVR的相关性。采用Student’s t检验比较治疗前后RV／LV-FDG的变化。应用Log—rank检验分析RV／LV—FDG≥1．15与RV／LV—FDG〈1．15的患者的生存时间均数差异。结果24例患者RV／LV—FDG与mPAP（r=0．562,P〈0．01）、RV／LV-FDG与PVR（r=0．574,P〈0．01）均呈直线相关。RV／LV—FDG与血浆NT—proBNP无显著相关性（r=0．181,P〉0．05）,但与ET-1呈直线相关（r=0．669,P〈0．01）。药物治疗有效的6例患者RV／LV-FDG从治疗前的1．38±0．52降至0．92±0．26（t=4．018,P〈0．05）;而治疗无效的9例患者,RV／LV-FDG治疗前后差异均无统计学意义（t=1．861,P〉0．05）。24例患者平均随访时间（21±8）个月,RV／LV—FDG≥1．15患者的生存时间均数为28个月（95％可信区间24～32个月）,明显低于RV／LV-FDG〈1．15的患者的生存时间均数34个月（95％可信区间33～35;χ^2=3．956,P〈0．05）。结论应用^18F-FDG心肌SPECT代谢显像检测右室心肌的葡萄糖代谢水平能够反映IPAH血流动力学改变的严重程度,同时对于药物疗效判断以及预后评估具有重要意义。     

Striatal dopamine transporter imaging correlates with anxiety and depression symptoms in Parkinson's disease.

We studied the correlation of striatal dopamine transporter (DAT) imaging with anxiety and depression symptoms in Parkinson's disease (PD). METHODS: Patients with idiopathic PD (n = 76) and age-matched healthy volunteers (n = 46) underwent SPECT brain scans with (99m)Tc-TRODAT-1, a radiolabeled tropane that selectively binds to the DAT. TRODAT-1 distribution volume ratios, a reflection of DAT availability, were calculated from the SPECT scan data for 6 regions of interest (ROIs) in the caudate and putamen. The association between neuropsychiatric symptoms (anxiety, depression, and fatigue) and DAT availability was explored for both subject groups, and the impact of disease severity on this association was examined in the PD group. RESULTS: PD patients showed lower DAT availability than did healthy volunteers in all examined regions (for all ROIs, P < 0.001). In PD patients, higher individual affective measures (for anxiety, r = -0.30 and P = 0.01; and for depression, r = -0.24 and P = 0.05) and total affect scores (r = -0.31; P = 0.01) were associated with diminished left anterior putamen DAT availability. The association between total affect scores and DAT availability was present only in the subset of patients with less severe PD (r = -0.35; P = 0.04), but subjects with the highest DAT availability did not show high total affect scores. No association between neuropsychiatric measures and DAT availability was found in the controls. CONCLUSION: These preliminary findings suggest that decreased DAT availability may be necessary for but not invariably associated with the development of affective symptoms in PD. This suggestion is consistent with previous research showing a link between depression and basal ganglia impairment, particularly involving the left hemisphere, and extends this finding to include anxiety.     

Dynamic and static 99mTc-ECD SPECT imaging of subacute cerebral infarction: comparison with 133Xe SPECT.

99mTc-ethylcysteinate dimer (99mTc-ECD) SPECT imaging reportedly fails to show reflow hyperemia in patients with subacute stroke. This study attempts to determine the clinical usefulness of dynamic 99mTc-ECD SPECT in evaluating regional blood flow in subacute cerebral infarction and the kinetic behavior of 99mTc-ECD in infarct areas. METHODS: 133Xe and consecutive dynamic and static 99mTc-ECD SPECT studies were performed on 24 patients with cortical infarction in the middle cerebral artery territory 13-15 d after the onset of a stroke. Image contrast between infarct and contralateral control areas on 99mTc-ECD tomograms (ECD uptake ratio) was compared with that on cerebral blood flow (CBF) images obtained using 133Xe inhalation (CBF ratio). RESULTS: In all cases, ECD uptake ratios from static images were lower than CBF ratios. This tendency was obvious when CBF in the infarct area increased above the normal control value, and no significant correlation was found between ECD uptake ratios from static images and CBF ratios. Only in the infarct areas with CBF below the normal control value, however, was a significant correlation between the two maintained (r = 0.795; P = 0.0011). A very strong correlation was found between CBF ratios and ECD uptake ratios on both the first dynamic scan (36 s after injection) (r = 0.991; P < 0.0001) and the second dynamic scan (72 s after injection) (r = 0.945; P < 0.0001). The correlation coefficient decreased in a time-dependent manner, with no significant correlation observed after the fourth dynamic scan (144 s after injection). On the other hand, significant correlations were observed on all dynamic scans only in the infarct areas with CBF below the control value. CONCLUSION: Super-early images of dynamic 99mTc-ECD SPECT provide a close imaging contrast with CBF and reveal reflow hyperemia in areas with irreversible changes produced by subacute stroke, which static 99mTc-ECD SPECT images fail to show. Decreased retention of the tracer in the infarct areas with hyperperfusion causes an underestimation of CBF on static 99mTc-ECD SPECT images. Given these results, we believe that dynamic 99mTc-ECD SPECT is an effective clinical tool to evaluate regional blood flow in subacute cerebral infarction.