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Purpose: The purpose of this study was to determine the clinical value of applying Tc-99m TRODAT-1 single photon emission computed tomography (SPECT) of the dopamine transporter to evaluate disease severity in young patients with symptomatic or asymptomatic Wilson disease (WD)., Materials and Methods: The evaluation of Tc-99m TRODAT-1 SPECT was performed in 18 patients with symptomatic WD, 13 patients with asymptomatic WD, and, as controls, 12 normal volunteers matched for age and gender. The neurologic symptoms of symptomatic patients were evaluated by an experienced neurologist. The ratios of specific striatal Tc-99m TRODAT-1 binding [with the cerebellum (CB) as the reference region] were calculated as striatum (ST)/CB and compared among the 3 groups. Using correlation analysis, the ratios for the WD patients were compared with clinical data on the severity of neurologic symptoms., Results: Significant differences of ST/CB ratios were found among the 3 groups (Sym vs. Nor, P = 0.000; Asym vs. Nor, P = 0.036; Sym vs. Asym, P = 0.011, respectively). In 23 patients (18 with symptomatic WD, 5 with asymptomatic WD), the posterior putamina showed more remarkable deformation and decreased radiotracer uptake. The ST/CB ratios correlated negatively with the severity of neurologic symptoms (r = -0.80, P < 0.01)., Conclusions: The decreased striatal Tc-99m TRODAT-1 uptake found in young WD patients, including symptomatic WD and some asymptomatic WD, as detected with SPECT, seems to indicate presynaptic damage of the dopaminergic nerve terminals. The decrease in radiotracer uptake was more prominent in the posterior putamina than in the caudate heads. The Tc-99m TRODAT-1 SPECT method can be used effectively for evaluating disease severity in WD.

Objective: To compare three-dimensional sonography with two-dimensional sonography for diagnosis of gallbladder diseases., Methods: Sixty-three patients with gallbladder diseases were examined with two- and three-dimensional sonography. The morphologic features presented on both modalities were analyzed, and the diagnostic accuracies of both modalities were evaluated and compared., Results: Both two- and three-dimensional sonography facilitated correct diagnosis in all patients with gallstones. Three-dimensional sonography had no influence on the diagnosis of gallstones compared with two-dimensional sonography. Three-dimensional sonography showed the granular surfaces in 18 (81.8%) of 22 cases of polypoid lesions and the pedunculated fundus in 19 (86.4%) of 22, whereas two-dimensional sonography displayed them in 10 (45.5%) and 3 (13.6%) of 22, respectively (P < .05 and .001). Three- and two-dimensional sonography made correct differential diagnoses between non-neoplastic and neoplastic polyps in 20 (90.9%) and 12 (54.5%) of 22, respectively (P < .05). In gallbladder carcinoma, both three- and two-dimensional sonography accurately showed all the associated gallstones and intrahepatic bile duct dilatation. Two-dimensional sonography could not correctly define the locations of the lesions in 2 (28.6%) and tumor extension in 1 (14.3%) of 7 cases with pathologically proved gallbladder cancer, whereas three-dimensional sonography improved the diagnosis in these cases., Conclusions: Three-dimensional sonography adds no advantages for diagnosis of gallstones compared with two-dimensional sonography, but it is better than two-dimensional sonography for differential diagnosis of gallbladder polyps and may improve the localization and staging for gallbladder carcinoma; however, additional studies are needed for further determination.