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[11C]CFT脑多巴胺转运体PET显像对帕金森病诊断和严重程度评估的应用

Application of [11C] CFT dopamine transporter PET imaging in the diagnosis and severity assessment of Parkinson disease

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【作者】 冼文彪史新冲张祥松江璐璐刘妍梅郑一帆唐刚华裴中黎锦如刘焯霖陈玲

【Author】 XIAN Wenbiao;SHI Xinchong;ZHANG Xiangsong;JIANG Lulu;LIU Yanmei;ZHENG Yifan;TANG Ganghua;PEI Zhong;LI Jinru;LIU Zhuolin;CHEN Ling;Department of Neurology, National Key Clinical Department,National Key Discipline, Guangdong key laboratory for diagnosis and treatment of major neurological diseases, The First Affiliated Hospital of Sun Yat-sen University;

【机构】 中山大学附属第一医院神经科,教育部国家重点学科,卫生部国家临床重点专科,广东省重大神经疾病诊治研究重点实验室中山大学附属第一医院核医学科

【摘要】 目的探讨[11C]CFT脑多巴胺转运体(dopamine transporer,DAT)正电子发射断层显像(positron emission tomography,PET)在帕金森病(Parkinson disease,PD)诊断和病情严重度评估的应用价值。方法对38例PD患者进行[11C]CFT PET显像,分析[11C]CFT PET和帕金森病统一评分量表第三部分(unified Parkinson disease rating scale partⅢ,UPDRSⅢ)评分的相关性。采用统计参数图(statistical parametric mapping,SPM)比较早、晚期PD患者DAT分布的差异。结果 PD患者双侧纹状体[11C]CFT摄取值显著降低。纹状体[11C]CFT摄取值与PD患者UPDRSⅢ、强直、运动迟缓、姿势、步态评分均呈显著负相关。早期PD患者纹状体DAT分布呈双侧不对称降低,起病对侧壳核、尾状核均显著降低,起病同侧以壳核外侧部降低为主。晚期PD患者纹状体DAT分布呈对双侧称性显著降低,与早期PD组相比,DAT逐渐发展至起病同侧壳核和双侧尾状核进一步降低。结论 [11C]CFT PET显像是PD诊断、病情严重程度评估一个良好指标。

【Abstract】 Objective To investigate the clinical value of [11C]CFT PET in the diagnosis and severity assessment of Parkinson disease(PD).MethodsThirty-eight patients with PD at various Hoehn & Yahr(H&Y) stages were included and underwent a [11C]CFT PET scan. The correlation between [11C]CFT uptake and unified Parkinson disease rating scale part III(UPDRS III) of PD patients was evaluated by calculating Pearson’s regression coefficient. Statistical parametric mapping(SPM) analysis was performed to compare the difference of dopamine transporter(DAT) distribution between early and advanced PD patients.ResultsThere was a significant reduction of [11C]CFT uptake in the bilateral striatum of PD patients. There was a significant negative correlation between clinical scores of UPDRS III, rigidity, bradykinesia, posture, gait and [11C]CFT uptake in the striatum. The SPM analysis revealed a significant and asymmetric decrease of [11C]CFT uptake in the striatum, predominantly on the putamen and caudate nucleus contralateral to the onset limb, in the posterior area of ipsilateral putamen in early PD(H&Y 1-2) patients compared with the normal controls. There was a significant symmetric decrease of [11C]CFT uptake in both putamen and caudate nucleus in advanced PD(H&Y 3-5) pa-tients, compared with normal controls. Compared with early PD patients, the reduction of DAT was more severe in bilateral caudate nucleus and the ipsilateral putamen in the advanced PD patients.Conclusions[11C]CFT PET is a sensitive biomarker in the diagnosis and assessment of disease severity of PD patients.

【基金】 广东省自然科学基金资助项目(编号:10151008901000187);广东省科技计划项目(编号:2006B36004021,2006B60501023,2010B080701107)
  • 【文献出处】 中国神经精神疾病杂志 ,Chinese Journal of Nervous and Mental Diseases , 编辑部邮箱 ,2014年08期
  • 【分类号】R742.5
  • 【被引频次】16
  • 【下载频次】366
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