Ichise M, Kim Y J, Erami S S, Ballinger J R, Vines D, Tanaka F, Lang A E
Department of Medical Imaging, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Nucl Med. 1999 Apr;40(4):530-8.
The purpose of this study was to evaluate whether striatal morphology on a three-dimensional surface display of 123I-2beta-carbomethoxy-3beta-(4-iodophenyl)tropane (123I-beta-CIT) SPECT data can be used as a diagnostic index for Parkinson's disease.
We studied 11 patients with mild Parkinson's disease and 21 age-matched controls. Triple-head SPECT scans were acquired for 30 min at 20 h after injection of 123I-beta-CIT. We measured the vertical height of the caudate head (H) and the length of the long axis of the striatum (L) on the three-dimensional surface display generated from SPECT data. The morphometric index of the striatum was defined as L/H. The power of L/H to discriminate Parkinson's disease and control groups was evaluated by discriminant function analysis and was compared with that of region of interest (ROI)-based 123I-beta-CIT binding measurements (V"3) and their ratios.
The mean L/H ratios (ipsilateral/contralateral) to the most affected limbs were (33%/45%) lower in the Parkinson's disease group compared with the control group, respectively. All other ROI-based measures confirmed that dopamine transporter reductions were most severe in the contralateral posterior putamen (a 68% reduction in V"3). In 1 patient with a subsequent clinical diagnosis of drug-induced parkinsonism, all SPECT measures were normal. The contralateral putamen contributed most to the discriminatory power, and the contralateral L/H showed the best discriminatory power of all SPECT measures.
These results suggest that striatal morphology on a three-dimensional display of 123I-beta-CIT SPECT data provides information of diagnostic significance for Parkinson's disease. This morphometry can be done without requiring technically demanding ROI analysis, and thus this technique may be suitable for routine clinical use.
本研究的目的是评估123I - 2β - 甲氧基羰基 - 3β -（4 - 碘苯基）托烷（123I - β - CIT）单光子发射计算机断层扫描（SPECT）数据的三维表面显示上的纹状体形态是否可作为帕金森病的诊断指标。
我们研究了11例轻度帕金森病患者和21名年龄匹配的对照者。在注射123I - β - CIT后20小时进行30分钟的三头SPECT扫描。我们在由SPECT数据生成的三维表面显示上测量尾状核头的垂直高度（H）和纹状体长轴的长度（L）。纹状体的形态学指标定义为L/H。通过判别函数分析评估L/H区分帕金森病组和对照组的能力，并与基于感兴趣区域（ROI）的123I - β - CIT结合测量值（V"3）及其比值进行比较。
与对照组相比，帕金森病组中受影响最严重肢体的平均L/H比值（患侧/对侧）分别降低了（33%/45%）。所有其他基于ROI的测量结果均证实多巴胺转运体减少在对侧后壳核最为严重（V"3降低68%）。在1例随后临床诊断为药物性帕金森综合征的患者中，所有SPECT测量结果均正常。对侧壳核对区分能力的贡献最大，对侧L/H在所有SPECT测量中显示出最佳的区分能力。
这些结果表明，123I - β - CIT SPECT数据的三维显示上的纹状体形态为帕金森病提供了具有诊断意义的信息。这种形态测量无需技术要求较高的ROI分析即可完成，因此该技术可能适用于常规临床应用。
