运用单光子发射计算机断层扫描显像诊断帕金森病和血管性帕金森综合征

目的探讨99Tcm-TRODAT-1{99Tcm-2β-N,N′-双(2-巯乙基)乙撑二胺基]甲基,3β-(4-氯苯基)托烷}脑显像在早期帕金森病(PD)和血管性帕金森综合征(VP)鉴别诊断中的意义。方法对确诊的47例早期PD患者、26例VP患者和30例年龄匹配的正常对照者分别进行99Tcm-TRODAT-1SPECT脑显像,应用计算机感兴趣区(regions ofinterest,ROI)技术分别计算各组双侧纹状体/小脑的放射性计数比值,并对结果进行比较分析。结果早期PD患者患肢对侧纹状体对99Tcm-TRODAT-1的摄取减少,患肢同侧和对侧纹状体/小脑的放射性计数比值均较正常对照者均值明显降低(P<0.05)。VP患者双侧纹状体区对99Tcm-TRODAT-1的摄取接近正常,患肢同侧和对侧纹状体/小脑的放射性计数比值与正常对照者双侧均值无显著差异(P>0.05)。结论99Tcm-TRODAT-1显像及半定量分析有助于PD的早期诊断及与VP的鉴别诊断。

Differential diagnosis of Parkinson disease and vascular Parkinsonism by single photon emission computed tomography imaging

Objective To investigate the differential diagnosis of early-stage Parkinson disease(PD) and vascular Parkinsonism(VP) by 99Tcm-TRODAT-1 single photon emission computed tomography brain imaging.Methods 99Tcm-TRODAT-1 SPECT brain imaging was performed on 47 patients with early-stage PD,26 with early-stage VP and 30 age-matched healthy control subjects.The radioactive ratio of striatum to cerebullum was calculated by region of interest(ROI) technique.The results were analyzed and compared.Results The distribution and quantities of 99Tcm-TRODAT-1 uptake were reduced in contralateral striatum to clinically symptomatic side of the patients with early-stage PD(P<0.05) while those were hardly different in two striatums of the patients with early-stage VP(P>0.05).The radioactive ratio of striatum to cerebullum contralateral to the affected limb in the patients with early-stage PD was lower than that in the healthy control subjects while that to patients with early-stage VP were similar to that in the healthy control subjects.Conclusion 99Tcm-TRODAT-1 single photon emission computed tomography brain imaging and semiquantitative analysis are useful to differentiate VP from PD.