11C-CFT PET/CT显像鉴别多系统萎缩与帕金森病的价值

摘要

目的 探讨11C-CFT PET/CT多巴胺转运蛋白(DAT)显像在鉴别多系统萎缩(MSA)与帕金森病(PD)中的应用价值.资料与方法 回顾性分析经临床确诊的21例MSA患者(MSA组)、24例PD患者(PD组)以及10例健康志愿者(正常对照组)的临床及11C-CFT PET/CT资料,采用感兴趣区(VOI)技术,计算纹状体不同区域(尾状核与壳核)DAT结合最指数与DAT结合不对称指数,分析3组纹状体DAT数量与分布对称性差异.结果 与正常对照组相比,MSA组与 PD组纹状体DAT结合量指数均显著减低,差异有统计学意义(P＜0.05);MSA组与PD组纹状体DAT结合量指数差异均无统计学意义(P＞0.05).与正常对照组相比,PD组纹状体DAT结合不对称指数显著增加,差异有统计学意义(P＜0.05),但MSA组纹状体DAT结合不对称指数与正常对照组差异无统计学意义(P＞0.05);PD组的尾状核与壳核DAT结合不对称指数均高于MSA组,差异有统计学意义(P＜0.05).结论 11C-CFT PET/CT显像可显示纹状体多巴胺能神经元退变情况.MSA与PD患者均表现为纹状体DAT数量减低,PD患者纹状体DAT分布不对称程度高于MSA患者.11C-CFT PET/CT显像可用于鉴别MSA与PD.%Purpose To investigate the value of 11C-CFT PET/CT dopamine transporter (DAT) imaging in differential diagnosis of multiple system atrophy (MSA) and Parkinson's disease (PD).Materials and Methods The 11C-CFT PET/CT images of clinically confirmed MSA patients (21 cases),PD patients (24 cases) and healthy adults (10 cases as normal control) were analyzed retrospectively.The volume of interest (VOI) were drawn manually,and the DAT binding indexes and asymmetry indexes of different regions of striatum,including caudate and putamen,were calculated.The differences of DAT binding indexes and asymmetry indexes among the above three groups were analyzed.Results Compared with the normal control group,the striatal DAT binding indexes of MSA group or PD group were significantly reduced (P＜0.05).There were no significant differences in DAT binding indexes between the MSA group and the PD group (P＞0.05).Compared with the normal control group,the DAT binding asymmetry indexes were significantly increased in the PD group (P＜0.05),but the indexes showed no significant differences in MSA group (P＞0.05).The DAT asymmetry indexes of caudate and putamen in the PD group were higher than those in the MSA group (P＜0.05).Conclusion 11C-CFT PET/CT imaging can detect the degeneration of dopaminergic neurons in striatum.The number of striatal dopamine transporters declines in both MSA and PD patients,but the asymmetry of striatal dapamine transporter in PD patients is higher than that in MSA patients.11C-CFT PET/CT can differentiate MSA and PD.