中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2009年
4期
263-267
,共5页
余大富%Mark A.Mintun
餘大富%Mark A.Mintun
여대부%Mark A.Mintun
阿尔茨海默病%痴呆%扣带回%体层摄影术,发射型计算机%PIB
阿爾茨海默病%癡呆%釦帶迴%體層攝影術,髮射型計算機%PIB
아이자해묵병%치태%구대회%체층섭영술,발사형계산궤%PIB
Alzheimer's disease%Dementia%Gyrus cinguli%Tomography,emission-computed%PIB
目的 研究人脑前扣带回皮质喙部(rACC)与[N-甲基-11C]2-[4'-(甲氨基)苯基]-6-羟基苯并噻唑(11C-PIB)的黏附能力(BP)对阿尔茨海默病型痴呆(DAT)的诊断价值.方法 受试对象为美国华盛顿大学医学院通过广告方式招募,按临床痴呆评定量表(CDR)评定的健康受试者(CDR=0)和痴呆患者(CDR>0),分别为129名和40例(其中有rACC PIB BP数据的健康受试者和DAT患者分别为120名和34例.所有169例受试者均有其他被研究脑局部的PIB BP数据).脑MRI用于脑局部精确定位.11C-PIB经肘静脉注射后行PET脑显像.用软件融合MRI和PET图像.用Logan分析软件计算BP.和其他脑局部比较,分析rACC部位PIB BP特点.采用SPSS 11.5软件对数据进行线性相关分析、t检验或方差分析.结果 有rACC PIB BP数据的健康受试者(CDR=0)和痴呆患者(CDR>0)分别为120例和34例,而所有169例受试者均有其他脑部位的PIB BP数据.rACC PIB BP和CDR呈直线相关(BP为0.2865±0.442,CDR为0.143±0.290,r=0.545,P<0.01).CDR=0.5和1的2组人群中rACC PIB BP值差异无统计学意义(0.6719±0.1545和0.8933 ±0.0880,t=-1.245,P>0.05),但CDR=0和>0的2组人群中差异有统计学意义(0.1589 ±0.0219和0.7370 ±0.1125,t=-7.998,P<0.01).rACC PIB BP的阈值为0.4592,用该阈值诊断DAT的灵敏度为67.65%(23/34),特异性为88.33%(106/120).DAT患者和健康人群之间BP有交叉在已被研究的脑局部中,DAT患者楔前回、rACC和额前回各自的PIB BP均值及这3个脑局部各自在DAT患者组和HC组间的PIB BP均值之差都高居前3位.结论 rACC PIB BP有鉴别诊断DAT的价值,rACC、楔前回、额前回均是用PIB BP诊断DAT的较敏感脑部区域.
目的 研究人腦前釦帶迴皮質喙部(rACC)與[N-甲基-11C]2-[4'-(甲氨基)苯基]-6-羥基苯併噻唑(11C-PIB)的黏附能力(BP)對阿爾茨海默病型癡呆(DAT)的診斷價值.方法 受試對象為美國華盛頓大學醫學院通過廣告方式招募,按臨床癡呆評定量錶(CDR)評定的健康受試者(CDR=0)和癡呆患者(CDR>0),分彆為129名和40例(其中有rACC PIB BP數據的健康受試者和DAT患者分彆為120名和34例.所有169例受試者均有其他被研究腦跼部的PIB BP數據).腦MRI用于腦跼部精確定位.11C-PIB經肘靜脈註射後行PET腦顯像.用軟件融閤MRI和PET圖像.用Logan分析軟件計算BP.和其他腦跼部比較,分析rACC部位PIB BP特點.採用SPSS 11.5軟件對數據進行線性相關分析、t檢驗或方差分析.結果 有rACC PIB BP數據的健康受試者(CDR=0)和癡呆患者(CDR>0)分彆為120例和34例,而所有169例受試者均有其他腦部位的PIB BP數據.rACC PIB BP和CDR呈直線相關(BP為0.2865±0.442,CDR為0.143±0.290,r=0.545,P<0.01).CDR=0.5和1的2組人群中rACC PIB BP值差異無統計學意義(0.6719±0.1545和0.8933 ±0.0880,t=-1.245,P>0.05),但CDR=0和>0的2組人群中差異有統計學意義(0.1589 ±0.0219和0.7370 ±0.1125,t=-7.998,P<0.01).rACC PIB BP的閾值為0.4592,用該閾值診斷DAT的靈敏度為67.65%(23/34),特異性為88.33%(106/120).DAT患者和健康人群之間BP有交扠在已被研究的腦跼部中,DAT患者楔前迴、rACC和額前迴各自的PIB BP均值及這3箇腦跼部各自在DAT患者組和HC組間的PIB BP均值之差都高居前3位.結論 rACC PIB BP有鑒彆診斷DAT的價值,rACC、楔前迴、額前迴均是用PIB BP診斷DAT的較敏感腦部區域.
목적 연구인뇌전구대회피질훼부(rACC)여[N-갑기-11C]2-[4'-(갑안기)분기]-6-간기분병새서(11C-PIB)적점부능력(BP)대아이자해묵병형치태(DAT)적진단개치.방법 수시대상위미국화성돈대학의학원통과엄고방식초모,안림상치태평정량표(CDR)평정적건강수시자(CDR=0)화치태환자(CDR>0),분별위129명화40례(기중유rACC PIB BP수거적건강수시자화DAT환자분별위120명화34례.소유169례수시자균유기타피연구뇌국부적PIB BP수거).뇌MRI용우뇌국부정학정위.11C-PIB경주정맥주사후행PET뇌현상.용연건융합MRI화PET도상.용Logan분석연건계산BP.화기타뇌국부비교,분석rACC부위PIB BP특점.채용SPSS 11.5연건대수거진행선성상관분석、t검험혹방차분석.결과 유rACC PIB BP수거적건강수시자(CDR=0)화치태환자(CDR>0)분별위120례화34례,이소유169례수시자균유기타뇌부위적PIB BP수거.rACC PIB BP화CDR정직선상관(BP위0.2865±0.442,CDR위0.143±0.290,r=0.545,P<0.01).CDR=0.5화1적2조인군중rACC PIB BP치차이무통계학의의(0.6719±0.1545화0.8933 ±0.0880,t=-1.245,P>0.05),단CDR=0화>0적2조인군중차이유통계학의의(0.1589 ±0.0219화0.7370 ±0.1125,t=-7.998,P<0.01).rACC PIB BP적역치위0.4592,용해역치진단DAT적령민도위67.65%(23/34),특이성위88.33%(106/120).DAT환자화건강인군지간BP유교차재이피연구적뇌국부중,DAT환자설전회、rACC화액전회각자적PIB BP균치급저3개뇌국부각자재DAT환자조화HC조간적PIB BP균치지차도고거전3위.결론 rACC PIB BP유감별진단DAT적개치,rACC、설전회、액전회균시용PIB BP진단DAT적교민감뇌부구역.
Objective Beta-amyloid (AB) plaque is one of the most important hallmarks of Alzhe-imer disease (AD). [N-methyl-11C]-[4'-methylaminophenyl]-6-hydroxybenzothiazole (11C-PIB) can have a strong binding potential (BP) of AB plaques in the brains of patients with dementia of Alzheimer type (DAT). This study was to investigate the value of rostral anterior cingnlate cortex (rACC) in diagnosing human AD with 11C-PIB PET imaging. Methods All the subjects were enrolled through ads by Washington University School of Medicine (WUSM) in USA. Clinical dementia rating (CDR) was the practical grading standard for AD. There were 129 cases of normal control (HC) with CDR =0 and 40 cases of AD patients with CDR >0 (but there were only 120 HC cases and 34 DAT patients with data of rACC PIB BP. All 169 cases had PIB BP data of other studied cerebral subregions). Brain subregions were localized with MRI. PET imaging was performed immediately after intravenous injection of11C-PIB. MRI and PET images were aligned and fused with the help of software. BP was calculated using the Logan graphical analysis and the cerebellar cortex as the reference tissue. The distribution characters of 11C-PIB BP in rACC were analyzed and compared with other brain subregions studied by other scholars with the same research cases. The corre-lation analysis, t-test or variance analysis were calculated with SPSS 11.5. Results rACC PIB BP of 120 HC and 34 AD patients was calculated, rACC PIB BP was statistically linear and positively correlated with CDR significantly (BP=0.2865±0.442,CDR=0.143±0.290,r=0.545,P<0.01). There was no sta-tistical difference among the rACC PIB BP of DAT patients (0.6719±0.1545 vs 0.8933±0.0880,inde-pendent-samples t-test in both groups of CDR =0.5and1, indicated t=-1.245,P>0.05), but signifi-cant difference was found between rACC PIB BPs of HC and DAT patients (0.1589±0.0219 vs 0.7370±0.1125, independent-samples t-test in both group of CDR=0 and>0,indicatedt=-7.998, P<0.01). The threshold of rACC PIB BP for differentiating DAT was 0.4592, greater than what could be thought as suffering from DAT with sensitivity 67.65 % (23/34) and specificity 88.33% (106/120). The BP values of both groups partially overlap each other. In all the studied cerebral subregions, the highest 3 subregions in mean PIB BP of DAT patients or in the difference of mean PIB BP between DAT patients and HC group were precuneus, rACC and prefrontal cortices. Conclusion rACC PIB BP can be used to differentiate DAT patients from normal persons; rACC, precuneus and prefrontal cortices are together the most sensitive brain subregions in the diagnosing DAT.
