脑多巴胺转运体SPECT鉴别帕金森病与血管性帕金森综合征

目的:多巴胺转运体(Dopamine transporter,DAT)99mTc-TRODAT-1SPECT显像有利于客观评价中枢多巴胺神经元的数量及其功能,本研究探讨DAT显像评估鉴别帕金-森病(PD)与血管性帕金森综合征(VP)的意义。方法:对临床确诊的51例PD患者和12例VP患者进行99mTc-TRODAT-1DATSPECT断层显像。注射示踪剂2-3h后采集图像,勾画出感兴趣区(双侧纹状体和枕叶),计算机自动计算感兴趣区的放射性计数,最后测算出纹状体与枕叶部位的放射性计数比值和非对称性指数并进行比较分析。结果:PD组特异性放射性比值是症状对侧0.38±0.18.症状同侧0.46±0.22,两侧差异有显著性(P<0.05)。VP组特异性放射性比值是左侧0.58±0.16.右侧0.56±0.32,两侧无显著性差异。VP组非对称性指数是6.72±10.53,PD组19.31±16.15,特异性放射性比值和非对称性指数组间比较均有显著性差异(P<0.05)。结论:多巴胺转运体99mTc-TRODAT-1SPECT显像有助于PD与VP的鉴别。

Differential diagnosis of Parkinson disease and vascular parkinsonism by99mTc-TRODAT-1 SPECT imaging of dopamine transporter

Objective: The imaging of dopamine transporter (DAT) with 99m Tc-TRODAT-1 and SPECT has been re-cently proposed to be a valuable and feasible means of the integrity and function of dopamine neurons. The aim of this study was to use brain SPECT to differentiate vascular parkinsonism (VP) from Parkinson disease (PD) . Methods: SPECT imaging with 99mTc-TRODAT-1 was conducted in 51 PD patients(age range, 57. 50-77y, mean age 60. 50±7. 55y)and 12 VP patients(age range, 62. 30-78. 50y, mean age 64. 50±12. 52y). All cases were conducted of Hoehn-Yahr classification at first . The images were obtained 2-3h after the intravenous injection of the tracer. The regions of intresting including bilateral striatum(ST) and occiptal lobe (OC) were figured, and radioactivity counts of three regions were got by computer automatically. At last the ratio of specific radioactivity uptake and asymmtry indexes of the two groups were calculated and compared. Results: the ratios of specific radioactivity uptaking in PD groups was 0. 38±0. 18 (side contralateral to onset or more severe limb), 0. 46±0. 22 (ipsilateral side). The ratios of specific radioactivity uptaking in VP group was 0. 58±0. 16 (left), 0. 56±0. 32 (right). The asymmetry index was 19. 31±16. 15 in PI) group . 6. 72±10. 53 in VP group. The difference of the ratios of specific ratioactivity uptake and asymmetry index between the two groups were significant P<0. 05). Conclusion: The dopamine transporter SPECT imaging with 99mTc-TRODAT-l can help us to differentiate VP from PD.