宋天彬,俞美香,祖莅惠,乔洪文,杨宏伟,帅冬梅,许二赫,张春,卢洁.18F-FP-DTBZ PET/CT鉴别不同类型帕金森综合征[J].中国医学影像技术,2023,39(10):1461~1466
18F-FP-DTBZ PET/CT鉴别不同类型帕金森综合征
18F-FP-DTBZ PET/CT for differentiating different types of Parkinsonism
投稿时间:2023-06-19  修订日期:2023-09-22
DOI:10.13929/j.issn.1003-3289.2023.10.005
中文关键词:  帕金森障碍  正电子发射断层显像  体层摄影术,X线计算机
英文关键词:Parkinsonian disorders  positron emission tomography  tomography, X-ray computed
基金项目:国家重点研发计划项目(2022YFC2406900)。
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 
 
俞美香 延边大学附属医院核医学科, 吉林 延边 133000  
祖莅惠 吉林大学中日联谊医院放射线科, 吉林 长春 130021  
乔洪文 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 
 
杨宏伟 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 
 
许二赫 首都医科大学宣武医院神经内科, 北京 100053  
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-FP-DTBZ PET/CT鉴别不同类型帕金森综合征的价值。方法 回顾性分析77例不同类型帕金森综合征患者的18F-FP-DTBZ PET/CT脑显像资料,包括21例帕金森病(PD)、35例多系统萎缩[MSA,含20例共济失调型(MSA-C)及15例帕金森型(MSA-P)]、12例进行性核上性麻痹(PSP)、5例皮质基底节变性(CBD)及4例路易体痴呆(DLB)。采用视觉评估法分析不同类型帕金森综合征患者尾状核、壳核前部及壳核后部摄取18F-FP-DTBZ特点,比较PD、MSA-C、MSA-P、PSP、CBD及DLB与健康志愿者(对照组)标准摄取值比值(SUVR)的差异。结果 PD多表现为双侧尾状核摄取正常或减低,双侧壳核摄取不对称性减低并以单侧后部为著。MSA-C存在2种代谢模式:双侧尾状核摄取正常或减低、双侧壳核摄取多呈均匀对称性减低,且后部减低程度大于前部;或双侧尾状核及壳核摄取均正常。MSA-P双侧尾状核摄取可正常或减低,双侧壳核摄取不对称性减低、少数可对称性减低。PSP双侧尾状核摄取多减低,双侧壳核摄取均匀、对称性减低,壳核摄取减低程度大于尾状核。CBD双侧尾状核摄取多不对称性减低、少数可正常,双侧壳核摄取不对称性减低则多见于后部。DLB多表现为双侧尾状核摄取减低,双侧壳核摄取均匀、对称性减低。PD、MSA-C、MSA-P、PSP、CBD及DLB组与对照组尾状核、壳核前部及壳核后部SUVR组间差异均有显著统计学意义(P均<0.000 1);PD、MSA-C、MSA-P、PSP、CBD及DLB组尾状核、壳核前部及壳核后部SUVR两两组间差异均无统计学意义(P均>0.05)。结论 18F-FP-DTBZ PET/CT有助于鉴别不同类型帕金森综合征。
英文摘要:
      Objective To observe the value of 18F-FP-DTBZ PET/CT for differentiating different types of Parkinsonism. Methods 18F-FP-DTBZ PET/CT brain metabolic data of 77 patients with different types of Parkinsonism, including 21 cases of Parkinson's disease (PD), 35 of multiple system atrophy (MSA, 20 cases of Parkinson-type [MSA-C] and 15 cases of cerebellum-type [MSA-P]), 12 of progressive supranuclear palsy (PSP), 5 of corticobasal degeneration (CBD) and 4 cases of dementia with Lewy body (DLB) were retrospectively analyzed. Visual evaluation was performed to analyze 18F-FP-DTBZ radiation uptake characteristics of the caudate nucleus, anterior putamen nucleus and posterior putamen nucleus in different types of Parkinsonism. The standard uptake value ratio (SUVR) were quantitatively compared among PD, MSA-C, MSA-P, PSP, CBD, DLB groups and healthy volunteers (control group). Results PD was mostly characterized by normal or decreased radiation uptake in bilateral caudate nuclei, and asymmetrically decreased uptake in bilateral putamen nuclei, especially in unilateral posterior region. The uptake of MSA-C could be normal or decreased in bilateral caudate nucleus, while symmetrically and evenly decreased in bilateral putamen nuclei, and the degree of reduction in posterior was greater than anterior. Meanwhile, normal radiation uptake could be observed in both caudate nucleus and putamen. MSA-P was mostly characterized by normal or decreased uptake in bilateral caudate nuclei and asymmetrically decreased uptake in bilateral putamen nucleus, also symmetrically decreased uptake in few cases. PSP was mostly characterized by decreased uptake in bilateral caudate nuclei and symmetrically decreased uptake in bilateral putamen nuclei, and the degree of reduction in putamen nuclei were greater than in caudate nuclei. In CBD patients, symmetrically decreased radiation uptake in bilateral putamen nuclei were more common than normal uptake, while asymmetrically decreased uptake in bilateral putamen nuclei were more common in the posterior region. DLB was mostly characterized by decreased uptake in bilateral caudate nuclei, and symmetrical and even decreased uptake in bilateral putamen nuclei. Significant differences of SUVR in caudate nuclei, anterior putamen and posterior putamen were found between PD, MSA-C, MSA-P, PSP, CBD, DLB group and control group (all P<0.000 1), but not of SUVR in caudate nuclei, anterior putamen nor posterior putamen between PD, MSA-C, MSA-P, PSP, CBD nor DLB group (all P>0.05). Conclusion 18F-FP-DTBZ PET/CT was helpful for distinguishing different types of Parkinsonism.
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