18F-DOPA和18F-FP-CIT显影剂在PET/CT诊断早期帕金森病及评估疾病严重程度中的应用价值

［摘要］　目的　探讨¹⁸F-DOPA和¹⁸F-FP-CIT显影剂在正电子发射计算机断层/电子计算机断层扫描（PET/CT）诊断早期帕金森病（PD）及评估疾病严重程度中的应用价值。方法　回顾性分析2022年1月至2023年3月四川省医学科学院·四川省人民医院神经内科收治的119例PD患者（PD组）的临床资料，另选择同期年龄、性别与PD组患者相匹配的健康体检者28名作为对照组。PD组及对照组均接受PET/CT检查。PD组有50例使用¹⁸F-DOPA显影剂（¹⁸F-DOPA-PD组），69例使用¹⁸F-FP-CIT显影剂（¹⁸F-FP-CIT-PD组）；对照组有14例使用¹⁸F-DOPA显影剂（¹⁸F-DOPA-对照组），14例使用¹⁸F-FP-CIT显影剂（¹⁸F-FP-CIT-对照组）。比较各组一般临床资料、视觉评分，以及纹状体尾状核、壳核摄取指数，探讨PD患者纹状体尾状核、壳核摄取指数与年龄、病程及UPDRS Ⅲ评分的相关性。结果　¹⁸F-DOPA-PD组和¹⁸F-FP-CIT-PD组纹状体尾状核、壳核的摄取指数均较对照组显著降低（P<0.05），且起病对侧尾状核、壳核的摄取指数降低情况较起病侧更为显著（P<0.05）。无论是使用¹⁸F-DOPA显影剂还是¹⁸F-FP-CIT显影剂，中晚期PD患者的尾状核、壳核摄取指数均较早期PD患者更低，差异有统计学意义（P<0.05）。¹⁸F-DOPA-PD组起病侧和对侧的尾状核、壳核前份、壳核中后份摄取指数与患者年龄、病程及UPDRS Ⅲ评分呈负相关（P<0.05）。¹⁸F-FP-CIT-PD组患者起病侧和对侧的尾状核、壳核前份、壳核中后份摄取指数与患者病程及UPDRS Ⅲ评分呈负相关（P<0.05），但与年龄的相关性不显著（P>0.05）。结论　¹⁸F-DOPA及¹⁸F-FP-CIT显影剂均能在PET/CT中反映PD患者脑内多巴胺能神经元变性情况，有助于早期筛查PD患者并进行疾病进程评估。

The application value of 18F-DOPA and 18F-FP-CIT contrast agents in diagnosing early Parkinson′s disease and assessing the severity of the disease in PET/CT

［Abstract］　Objective　To explore the application value of ¹⁸F-DOPA and ¹⁸F-FP-CIT contrast agents in diagnosing early Parkinson′s disease(PD) and assessing the severity of the disease in positron emission tomography/computed tomography(PET/CT). Methods　The clinical data of 119 PD patients(PD group) admitted to Department of Neurology, Sichuan Academy of Medical Sciences·Sichuan Provincial People′s Hospital from January 2022 to March 2023 were retrospectively analyzed. Other 28 individuals receiving healthy physical examination and matching the age and gender of the patients in the PD group during the same period were selected as the control group. Both the PD group and the control group received PET/CT examination. In the PD group, 50 cases received a contrast agent of ¹⁸F-DOPA(¹⁸F-DOPA-PD group) and 69 cases received a contrast agent of ¹⁸F-FP-CIT(¹⁸F-FP-CIT-PD group). In the control group, 14 cases received a contrast agent of ¹⁸F-DOPA(¹⁸F-DOPA- control group) and 14 cases received a contrast agent of ¹⁸F-FP-CIT(¹⁸F-FP-CIT- control group). The general clinical data, Visual Analogue Scale scores, and striatum caudate nucleus and putamen uptake indices were compared among all groups. The correlation of striatum caudate nucleus and putamen uptake indices with age, course of disease and Unified Parkinson′s Disease Rating Scale Part Ⅲ(UPDRS Ⅲ) scores in the PD patients was explored. Results　The striatum caudate nucleus and putamen uptake indices in the ¹⁸F-DOPA-PD group and the ¹⁸F-FP-CIT-PD group were significantly lower than those in the control group(P<0.05), and the decreases in the striatum caudate nucleus and putamen uptake indices on the contralateral side of the onset side were more significant than those on the onset side(P<0.05). Regardless of whether ¹⁸F-DOPA contrast agent or ¹⁸F-FP-CIT contrast agent was used, the striatum caudate nucleus and putamen uptake indices in the patients with mid- to late-stage PD were lower than those in the patients with early-stage PD, and the differences were statistically significant(P<0.05). In the ¹⁸F-DOPA-PD group, the uptake indices of the striatum caudate nucleus, anterior putamen, middle and posterior section of the putamen on the onset side and the contralateral side were negatively correlated with the patients′ age, course of disease and UPDRS Ⅲ scores(P<0.05). In the ¹⁸F-FP-CIT-PD group, the uptake indices of the striatum caudate nucleus, anterior putamen, middle and posterior section of the putamen on the onset sides and the contralateral sides of the patients were negatively correlated with the patients′ course of disease and UPDRS Ⅲ scores(P<0.05), but were not significantly correlated with the patients′ age(P>0.05). Conclusion　Both ¹⁸F-DOPA and ¹⁸F-FP-CIT contrast agents can reflect the degeneration of dopaminergic neurons in the brain of PD patients in PET/CT, which are helpful for early screening of PD patients and assessment of the disease progression.