D2-Rezeptorszintigraphie (¹²³J-IBZM) im Vergleich zur zerebralen Perfusion (^99mTc-HMPAO) bei extrapyramidalen Erkrankungen^[*]

Zusammenfassung

Ziel der Studie war es, zu überprüfen ob eine Korrelation zwischen zerebraler Perfusion (^99mTc-HMPAO) und D2-Rezeptorbindung (¹²³J-IBZM) bei extrapyramidalen Erkrankungen besteht. 13 Patienten mit Parkinson-Syndrom und 13 Patienten mit extrapyramidalen Hyperkinesien wurden untersucht. Bei allen Patienten wurden SPECT-Studien mit ^99mTc-HMPAO und ¹²³J-IBZM im Abstand von 2 bis 7 Tagen durchgeführt. Die Auswertung erfolgte semiquantitativ zu Frontalhirn und Zerebellum als Referenzregion für die Basalganglien. Die Streuung der Quotienten Basalganglien/Referenz war in beiden Gruppen geringer, wenn das Frontalhirn als Referenz benutzt wurde. In der Gruppe der Patienten mit extrapyramidalen Hyperkinesien unterschieden sich die zwei Patienten mit Chorea Huntington durch ihre niedrigere Perfusion und die geringere D2-Rezeptorbindung in den Basalganglien von den übrigen Patienten mit extrapyramidalen Hyperkinesien. Es bestand keine Korrelation zwischen D2-Rezeptorbindung und regionalem zerebralen Blutfluß. Die Bestimmung der regionalen Perfusion bringt mit Ausnahme der Chorea Huntington keinen diagnostischen Zugewinn.

Summary

The aim of this SPECT study was to determine whether there is a correlation between rCBF (^99mTc-HMPAO) and D2 receptor binding (¹²³I-IBZM) in disorders of the extrapyramidal system and in which situation the ^99mTc-HMPAO scan could predict the outcome of the ¹²³I-IBZM study. 13 patients with Parkinson’s syndrome and 13 patients with hyperkinetic extrapyramidal disorders were studied. In all patients the two SPECT studies were performed within 2-7 days. ROIs were placed over the basal ganglia (BG), the frontal cortex (FC) and the cerebellum (CE). The ratios BG/FC and BG/CE were calculated. In both groups the scatter was lower when the frontal cortex was used as reference region. Among the patients with hyperkinetic extrapyramidal disorders the two patients with Huntington’s chorea had lower rCBF and D2 receptor binding compared to other hyperkinetic extrapyramidal disorders. There was no correlation between D2 receptor binding and rCBF in the basal ganglia. The ^99mTc-HMPAO studies did not provide clinically useful information, except in Huntington’s chorea.

Schlüsselwörter

IBZM-SPECT - extrapyramidale Erkrankungen - Morbus Parkinson - D2-Rezeptor

Key words

IBZM-SPECT - extrapyramidal disorders - Parkinson’s disease - D2 receptor

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