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目的:评价在早期诊断帕金森病(PD)中核素纹状体DAT显像的敏感方法。方法:同一患者先后进行18F-FP-CITPET、99Tcm-TRODAT-1和131I-FP-CITSPECT3种显像。共有6名正常人、21例早期PD和10例晚期PD患者参与。结果:18F-FP-CITPET纹状体DAT显像图像清晰;在早期PD中发现两侧纹状体DAT值不对称;病侧后壳核DAT减少特别明显;DAT损害区反映偏侧PD的吻合率为100%;能分清早、晚期PD。将18F-FP-CIT改为用碘标的131I-FP-CITSPECT后纹状体DAT显像不佳。99Tcm-TRODAT-1SPECT在早期PD诊断中类似于18F-FP-CIT,但无法早期发现病侧后壳核DAT值下降,DAT损害区反映偏侧PD的吻合率为81%。结论:18F-FP-CITPET纹状体DAT显像对早期PD诊断最佳。99Tcm-TRODAT-1纹状体DAT显像可用于早期PD诊断,适合国内目前应用。
PURPOSE: To evaluate the sensitive method for the early diagnosis of radionuclide DAT imaging in Parkinson’s disease (PD). Methods: The same patients were successively screened by 18F-FP-CITPET, 99Tcm-TRODAT-1 and 131I-FP-CITSPECT. A total of 6 normal subjects, 21 patients with early PD and 10 patients with advanced PD were involved. Results: DAT imaging of 18F-FP-CITPET striatum was clear. DAT values of striatum on both sides of the lesion were found to be asymmetric in the early stage of PD. DAT in the posterior putamen was significantly reduced. DAT lesion area showed an anastomosis of unilateral PD Rate of 100%; can distinguish early and late PD. The DAT imaging of striatum after substituting 18F-FP-CIT with iodine-labeled 131I-FP-CITSPECT was poor. 99Tcm-TRODAT-1 SPECT is similar to 18F-FP-CIT in early diagnosis of PD, but can not detect DAT value of retropharyngeal posterior putamen early, while DAT lesion area reflects 81% of unilateral PD coincidence rate. Conclusion: DAT imaging of 18F-FP-CITPET striatum is best for diagnosis of early PD. 99Tcm-TRODAT-1 striatum DAT imaging can be used for early PD diagnosis, suitable for the current application in China.