中华脑科疾病与康复杂志(电子版) 2016年6月,6卷3期

临床研究

18F-FDG PET在阿尔茨海默病临床评估中的初步应用

陶霖1 石吉乐1 孙洪赞2 马英1 佡剑非1 郑东明1

110022 沈阳,中国医科大学附属盛京医院神经内科1,放射科2
郑东明,Email:zhengdm@sj-hospital.org

摘要:目的 探讨18F标记的脱氧葡萄糖正电子发射断层显像(18F-FDG PET)对阿尔茨海默病(AD)病情评估的价值。方法 对10例AD患者和10例年龄、性别和文化程度匹配的健康老年人的头部18F-FDG PET进行分析。选取双侧海马、后扣带回、小脑为感兴趣区,测量并比较两组海马、后扣带回的FDG标准化摄取值(SUV)与小脑FDG的SUV比值之间的差异,并对AD组海马、后扣带回FDG低代谢程度与简易精神状态量表(MMSE)评分进行相关性分析。结果 轻度AD痴呆患者主要在后扣带回及双侧颞顶联合区的FDG摄取减少,中度AD患者的后扣带回、双侧颞顶联合区、海马及额叶皮质葡萄糖代谢减低明显,重度AD患者全脑皮质代谢广泛减低。AD组的双侧后扣带回/小脑的SUV比值(左侧0.83±0.33,右侧0.87±0.34)较正常对照组明显减低(左侧1.23±0.04,右侧1.31±0.04,P<0.01),双侧海马/小脑的SUV比值虽然也低于对照组,但差异无统计学意义(P>0.05)。AD患者海马及后扣带回的FDG代谢水平与MMSE评分显著相关,左、右侧海马和左、右侧后扣带回的FDG代谢水平与MMSE评分之间的相关系数分别为0.84(P<0.01)、0.74(P<0.05)和0.85(P<0.01)、0.87(P<0.01)。结论 AD患者的18F-FDG PET检查有助于评价AD患者痴呆的严重程度,FDG低代谢的范围和程度均与认知功能损害的程度相关。

关键词:阿尔茨海默病; 正电子发射断层显像术; 葡萄糖代谢障碍

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(编辑:沈承亮 收稿日期:2016-05-02)