PET、SPECT及MRS在帕金森病诊断中的应用

The application of PET、SPECT and MRS in Parkinson's disease

  • 摘要: PET和SPECT可以在体研究帕金森病患者黑质纹状体多巴胺能系统退变的神经化学、血流动力学及代谢改变,脑血流和代谢的激活研究表明,帕金森病患者补偿运动区和背侧额叶前部运动区的激活功能受损。纹状体多巴胺能神经元退变可以通过PET和SPECT进行定量分析,在帕金森病患者中纹状体对18F标记的多巴摄取明显下降,壳核比尾状核下降明显,且与运动异常症状的严重程度及病程呈负相关。PET和SPECT使无创评价多巴胺受体密度的变化成为可能。同时,MRS可以揭示脑内几种含氢含磷化合物的浓度变化。应用这些互相补充的技术可获得关于帕金森病脑功能的信息。

     

    Abstract: PET and SPECT provide the means to studying in vivo the neurochemical, hemodynamic or metabolic consequences of the degeneration of the nigrostriatal dopaminergic system in Parkinson's disease (PD). Activation studies using cerebral blood flow and metabolism measurements during a motor task reveal an impaired ability to activate the supplementary motor area and dorsolateral prefrontal cortex in PD. The extent of striatal dopaminergic denervation can be quantified with PET and SPECT. Striatal uptake of 18F-dopa is markedly decreased in PD, more in the putamen than in the caudate nucleus, and inversely correlates with the severity of motor signs and with duration of disease. PET and SPECT make possible the assessment by noninvasive means of the changes in dopamine receptor density. Meanwhile, MRS can reveal changes in concentra-tion of several hydrogenate and phosphoric compounds in the brain. The functional information of brain in PD can be obtained with these complementary techniques.

     

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