11CCFT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

摘要

Objective To investigate the clinical value of [11C]CFT PET in the diagnosis and severity assessment of Parkinson disease (PD). Methods Thirty-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 ear-ly and advanced PD patients. Results There 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, pos-ture, 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 sig-nificant 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 bilater-al 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.%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UP-DRSⅢ、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。