Tanaka F, Vines D, Tsuchida T, Freedman M, Ichise M
Department of Medical Imaging, University of Toronto, Ontario, Canada.
J Nucl Med. 2000 Sep;41(9):1456-64.
Normative ethyl cysteinate dimer (ECD) SPECT data must be available to successfully apply ECD SPECT to clinical studies. The purpose of this study was to determine ECD SPECT scan patterns of healthy adults.
Forty-eight healthy volunteers (22 men, 26 women; age range, 22-95 y; mean age, 47.6 +/- 19.2 y) underwent high-resolution ECD SPECT. For visual analysis of regional brain ECD uptake, we used a scale of +3 to -3, in which +3 and -3 indicated highest ECD uptake and deficit, respectively. For quantitative analysis, we measured the region-to-cerebellum ratio (R/CE) and the region-to-cerebral cortex ratio (R/CO) for 17 regions (13 cortical, 3 subcortical, and 1 cerebellar).
On visual analysis, no subject had a score of -3. All subjects had a score of -2 for the hippocampus and a score of +3 for the medial occipital cortex, except for 2 subjects who had a score of +3 for the striatum and thalamus. A frontal eye field and posterior parieto-occipital junction were identified in 60% of subjects with a score of +1 and 79% of subjects with a score of +2. On quantitative analysis, a significant regional variation (ANOVA, P < 0.0001) was seen in R/CE, ranging from 0.709 (hippocampus) to 1.26 (medial occipital cortex). However, regional right-to-left differences and intersubject variability of R/CE were small (asymmetry index, 3.6% +/- 0.8%; coefficient variation, 6.6% +/- 0.7%). R/CE declined significantly with age in 6 regions, including the anterior and posterior cingulate cortex, superior prefrontal and parietal cortex, striatum, and hippocampus (1.0%-2.0% per decade, P < 0.05), whereas R/CO in the cerebellum increased significantly with age (1.0% per decade, P < 0.05).
Although regional ECD brain perfusion patterns vary significantly, including variability caused by the age-related effect, intersubject variability is small. Recognition of these normal patterns is important for clinical interpretation of ECD SPECT studies.
必须有正常的半胱氨酸乙酯二聚体（ECD）单光子发射计算机断层扫描（SPECT）数据，才能成功地将ECD SPECT应用于临床研究。本研究的目的是确定健康成年人的ECD SPECT扫描模式。
48名健康志愿者（22名男性，26名女性；年龄范围22 - 95岁；平均年龄47.6±19.2岁）接受了高分辨率ECD SPECT检查。为了对区域脑ECD摄取进行视觉分析，我们使用了从+3到-3的评分标准，其中+3和-3分别表示最高的ECD摄取和缺损。为了进行定量分析，我们测量了17个区域（13个皮质区、3个皮质下区和1个小脑区）的区域与小脑比值（R/CE）和区域与大脑皮质比值（R/CO）。
在视觉分析中，没有受试者的评分为-3。除2名受试者纹状体和丘脑评分为+3外，所有受试者海马评分为-2，枕内侧皮质评分为+3。在评分+1的受试者中有60%、评分+2的受试者中有79%识别出额眼区和顶枕后交界区。在定量分析中，R/CE存在显著的区域差异（方差分析，P < 0.0001），范围从0.709（海马）到1.26（枕内侧皮质）。然而，R/CE的区域左右差异和受试者间变异性较小（不对称指数，3.6%±0.8%；变异系数，6.6%±0.7%）。R/CE在包括前扣带回和后扣带回皮质、前额叶和顶叶上皮质、纹状体和海马在内的6个区域随年龄显著下降（每十年1.0% - 2.0%，P < 0.05），而小脑中的R/CO随年龄显著增加（每十年1.0%，P < 0.05）。
尽管区域ECD脑灌注模式差异显著，包括与年龄相关效应引起的变异性，但受试者间变异性较小。认识这些正常模式对于ECD SPECT研究的临床解读很重要。
