摘要
目的探讨PET/CT脑代谢-脑血流同期显像对评估慢性意识障碍(CDC)患者的临床价值。方法回顾性分析2016年1月至2017年3月临床确诊的CDC患者[10例,男女各5例,年龄(50.9±17.2)岁]及健康对照组[10名,男女各5名,年龄(52.0±10.3)岁]的PET/CT脑葡萄糖代谢显像和脑血流灌注显像资料,采用一日法,首先进行13N-氨(Ammonia)脑血流灌注显像,然后行18F-脱氧葡萄糖(FDG)PET/CT脑代谢显像,测得2组受试者脑代谢及脑血流影像上大脑皮质各脑区及基底节、丘脑的平均标准摄取值(SUVmean),除以小脑的SUVmean,得到比值(SUVr)作为脑代谢值和脑血流值,并对患者组受损脑区与对照组相应脑区进行比较;研究脑代谢-脑血流影像学特点,并与临床评分进行比较。采用两样本t检验及Pearson相关分析数据。结果健康对照组脑代谢和脑血流图像上的放射性摄取呈左右对称。患者组的受损脑区代谢和血流均较健康对照组明显减低(t值:2.90~5.19,均P<0.05),代谢减低区表现在基底节和丘脑(各9例)、额叶和顶叶(各8例)、颞叶和枕叶(各7例);血流减低区中,7例在顶叶,其余各脑区均为6例。额叶、顶叶及基底节的代谢值和血流值与临床评分之间均呈正相关(r值:0.473~0.606,均P<0.05)。患者组脑代谢-脑血流匹配类型有3种:Ⅰ型(2例)为代谢-血流减低不匹配型,Ⅱ型(3例)为代谢-血流减低混合型;Ⅲ型(5例)为代谢-血流减低匹配型。Ⅰ、Ⅱ、Ⅲ型的临床评分均值分别为10.5、8.3、5.6。结论PET/CT脑代谢-脑血流同期显像可以获得代谢血流的不同影像学特点,有助于临床对意识障碍患者的意识状态进行评估。
Objective To investigate the value of PET/CT imaging of cerebral glucose metabolism (CGM) and cerebral blood flow (CBF) in evaluating chronic disorders of consciousness (CDC). Methods A total of 10 CDC patients (5 males, 5 females, age (50.9±17.2) years) and 10 healthy controls (5 males, 5 females, age (52.0±10.3) years) from January 2016 to March 2017 were recruited to perform brain PET/CT of CGM and CBF. The brain PET imaging using 13N-Ammonia was performed and followed by 18F-fluorodeoxyglucose (FDG) PET. The mean standardized uptake values (SUVmean) of frontal, parietal, temporal and occipital lobes as well as basal ganglia, thalamus were obtained. The SUVmean of cerebral regions/SUVmean of cerebellum ratios (SUVr) were acquired. The SUVr were compared between the patients and controls. The imaging characteristics of CGM and CBF were investigated, and their relationships with clinical scores were further analyzed. Two-sample t test and Pearson correlation analysis were used to analyze the data. Results The radioactive distribution in the brain of healthy controls was symmetrical. SUVr of cerebral regions in the affected side of patients were significantly lower than those of the controls both in CGM imaging and CBF imaging (t values: 2.90-5.19, all P<0.05). In 10 CDC patients, there were 9 with hypometabolism in basal ganglia and thalamus, 8 with hypometabolism in frontal and parietal lobes, and 7 with hypometabolism in temporal and occipital lobes. At the same time, there were 7 with parietal hypoperfusion and 6 with hypoperfusion in other cerebral regions in the CDC patients. In the frontal, parietal lobes and basal ganglia, the CGM and CBF were both correlated with the clinical scores (r values: 0.473-0.606, all P<0.05). Abnormal metabolism-perfusion patterns were divided into 3 types. Type Ⅰ included 2 patients and their hypometabolism and hypoperfusion were mismatched completely. Type Ⅱ included 3 patients and their hypometabolism and hypoperfusion were matched in frontal, parietal, occipital and t
作者
尚琨
卢洁
苏玉盛
李则
帅冬梅
梁志刚
Shang Kun;Lu Jie;Su Yusheng;Li Ze;Shuai Dongmei;Liang Zhigang(Department of Nuclear Medicine,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2018年第12期777-781,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家重点研发项目(2016YFC0103001).
