摘要
目的 评价葡萄糖代谢与多巴胺转运蛋白PET显像在偏侧帕金森病 (PD)患者诊断中的价值。方法 正常对照组 16例。偏侧PD患者 34例 ,Hoehn YahrⅠ～Ⅱ级。其中 16例偏侧 (右侧肢体 )PD患者进行1 8F 脱氧葡萄糖 (FDG)PET显像 ,18例偏侧 (右侧或左侧 )PD患者进行1 8F N (3 氟丙基 ) 2 β 甲酯基 3β (4′ 碘苯基 )去甲基托烷 (FP β CIT)显像 ,6例患者同时进行两种显像。静脉注射1 8F FDG 185～ 2 5 9MBq 30min后进行脑三维采集 ,结果应用感兴趣区 (ROI)半定量分析和统计参数地图 (SPM)分析。1 8F FP β CIT显像于注射后 2～ 3h进行 ,计算 (各ROI计数 -小脑计数 ) 小脑计数比值。结果 PD组与对照组比较 ,患侧肢体对侧基底节葡萄糖代谢减低 ,但差异无显著性。SPM分析结果示 ,PD患者与对照组比较 ,葡萄糖代谢减低位于左侧前额叶、中额叶、下额叶及左侧中颞叶 ,而摄取增加区域除双侧额叶中央前回、双侧顶叶楔前叶、左侧枕叶外 ,还累及左侧丘脑。偏侧PD患者豆状核后部1 8F FP β CIT摄取显著减低 ,且不仅见于症状对侧豆状核 ,同侧豆状核后部也可见摄取减低。结论 1 8F FDGPET显像对PD的早期诊断无特异性。1 8F FP β CIT可早期发现PD纹状体多巴胺转运蛋白的变化 ,有助于PD的早期诊断和鉴别诊断 ;与1 8F
Objective To study the characteristics of 18F-fluorodeoxyglucose (FDG) and 18F-N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane ( 18F-FP-β-CIT) PET imaging in patients with hemi-Parkinson's disease (hemi-PD) and to assess their value in early diagnosis. Methods 34 cases of hemi-PD (Hoehn and Yahr stage Ⅰ～Ⅱ)and 16 normal control subjects were selected for this study. 16 patients were performed with 18F-FDG PET imaging, 18 patients with 18F-FP-β-CIF, while 6 patients of them both 18F-FDG and 18F-FP-β-CIT. 30 min after injection of 185～259 MBq 18F-FDG, 3D brain scans were acquired. Region of interest (ROI) analysis and statistical parametric mapping (SPM) were applied. 18F-FP-β-CIT PET imaging was carried out 2～3 h post injection, and (ROI-cerebellum)/cerebellum ratio was calculated. Results In right hemi-PD, reductions in 18F-FDG metabolism were observed in the left basal ganglia compared with control group, but with no significant difference (P>0.05). The results of SPM analysis showed that a significant reduction in FDG uptake in the left superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus and left middle temporal gyrus, whereas a significant increase in the bilateral precentral gyrus, superior parietal lobule, left middle occipital gyrus and left thalamus as compared with the control group. There was a significant reduction in 18F-FP-β-CIT uptake in putamen, its reduction was found not only in the contralateral putamen, but also in the ipsilateral ones, and more pronounced in the contralateral posterior putamen. Conclusions 18F-FDG PET imaging is non-specific for the early diagnosis of PD. 18F-FP-β-CIT PET imaging could find the changes of striatum dopamine transporter at early stage, therefore it was helpful for early diagnosis and differential diagnosis of PD. Combined with 18F-FDG PET imaging, the changes of local cerebral glucose metabolism in PD could also be evaluated.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2003年第4期219-221,共3页
Chinese Journal of Nuclear Medicine
基金
"十五"国家科技攻关课题基金资助 (2 0 0 1BA70 2B0 2 )
