宋天彬,高珂梦,苏玉盛,李则,帅冬梅,李天女,唐立钧,张春,卢洁.18F-FDG PET/CT评估帕金森综合征脑葡萄糖代谢并鉴别其类型[J].中国医学影像技术,2022,38(7):989~994
18F-FDG PET/CT评估帕金森综合征脑葡萄糖代谢并鉴别其类型
18F-FDG PET/CT for evaluating cerebral glucose metabolism and differentiating types of Parkinsonism
投稿时间:2022-02-14  修订日期:2022-04-22
DOI:10.13929/j.issn.1003-3289.2022.07.006
中文关键词:  帕金森综合征  氟脱氧葡萄糖  正电子发射断层显像
英文关键词:Parkinson syndrome  fluorodeoxyglucose  positron-emission tomography
基金项目: 首都医科大学宣武医院汇智人才工程-支持计划-领军人才项目(HZ2021ZCLJ005)。
作者单位E-mail
宋天彬 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
高珂梦 南京医科大学第一附属医院核医学科, 江苏 南京 210029  
苏玉盛 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
李则 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
帅冬梅 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
李天女 南京医科大学第一附属医院核医学科, 江苏 南京 210029  
唐立钧 南京医科大学第一附属医院核医学科, 江苏 南京 210029  
张春 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
卢洁 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
imaginglu@hotmail.com 
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中文摘要:
       目的 观察18F-FDG PET/CT 评估帕金森综合征脑葡萄糖代谢并鉴别其类型的价值。方法 回顾性分析93例帕金森综合征患者脑PET/CT代谢显像,包括帕金森病(PD)20例、多系统萎缩(MSA)20例 、进行性核上性麻痹(PSP)20例、皮质基底节变性(CBD)13例及路易体痴呆(DLB)20例;以视觉法和Neuro-Q定量法评估脑代谢,分析各型疾病脑代谢特点,评价其鉴别诊断价值。结果 视觉法与Neuro-Q定量法评估代谢异常脑区的一致性高(Kappa=0.75,P<0.01)。Neuro-Q定量分析显示,PD特征性表现包括壳核、丘脑、中脑、脑桥及小脑代谢增高,额叶外侧及顶叶代谢减低。MSA-C以脑桥及小脑代谢减低为主;MSA-P以壳核、脑桥及小脑代谢减低为主;PSP以额叶内侧、额叶外侧、尾状核头、丘脑及中脑代谢减低为主;CBD以额叶内侧、额叶外侧、顶叶、壳核、尾状核头及丘脑代谢减低为主;DLB则表现为枕叶、顶叶葡萄糖代谢减低,壳核、脑桥及小脑代谢增高,而后扣带回代谢无明显变化。结论 18F-FDG PET/CT可较好地评估帕金森综合征脑葡萄糖代谢,并有助于鉴别其类型。
英文摘要:
      Objective To explore the value of 18F-FDG PET/CT for evaluating cerebral glucose metabolism and differentiating types of Parkinsonism. Methods Brain metabolic PET/CT data of 93 patients with Parkinsonism were retrospectively analyzed, including 20 cases of Parkinson disease (PD), 20 of multiple system atrophy (MSA) (14 of MSA cerebellar-type and 6 of MSA Parkinson-type), 20 of progressive supranuclear palsy (PSP), 13 of cortical basal ganglia degeneration (CBD) and 20 cases of dementia with Lewy body (DLB). Brain metabolism was evaluated with visual method and Neuro-Q quantitative method, the characteristics of different types of Parkinsonism were observed, and the differential diagnostic values were analyzed. Results The consistency between results of visual method and Neuro-Q quantitative method was high (Kappa=0.75, P<0.01). Neuro-Q quantitative analysis showed that PD mainly presented as the metabolisms of putamen, thalamus, midbrain, pons and cerebellum increased, while of lateral frontal lobe and parietal lobe decreased. MSA-C mainly presented as the metabolisms of pons and cerebellum decreased, MSA-P as the metabolisms of putamen, pons and cerebellum decreased, while PSP as the metabolisms of medial frontal lobe, lateral frontal lobe, caudate nucleus head, thalamus and midbrain decreased. CBD mainly presented as the metabolisms of medial frontal lobe, lateral frontal lobe, parietal lobe, putamen, caudate nucleus and thalamus decreased. DLB mainly presented as the metabolisms of occipital and parietal lobes decreased, and of putamen, pons and cerebellum increased, without obvious changes of posterior cingulate gyrus. Conclusion 18F-FDG PET/CT could be used to evaluate cerebral glucose metabolism in Parkinsonism, hence being helpful for differentiating different types of Parkinsonism.
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