中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
4期
348-350
,共3页
冯涛%赵性泉%芦林龙%张璇%王拥军
馮濤%趙性泉%蘆林龍%張璇%王擁軍
풍도%조성천%호림룡%장선%왕옹군
阿尔茨海默病%路易体痴呆%18F-脱氧葡萄糖%正电子发射断层扫描
阿爾茨海默病%路易體癡呆%18F-脫氧葡萄糖%正電子髮射斷層掃描
아이자해묵병%로역체치태%18F-탈양포도당%정전자발사단층소묘
Alzheimer's disease%Dementia with lewy bodies%Glucose%PET
目的 比较阿尔茨海默病与路易体痴呆在脑葡萄糖代谢方面的特征.方法 本研究入选了28例阿尔茨海默病(AD)患者和25例路易体痴呆(DLB)患者.受试者静脉注射示踪刺18F脱氧葡萄糖(18F-FDG),然后接受头部正电子发射断层扫描(PET).应用迭代法重建的脑图像,分别取额叶皮层、顶叶皮层、颞叶皮层、枕叶皮层、小脑皮层、尾状核头、壳核为感兴趣区(ROI).以脑内各ROI与小脑半球ROI的FDG摄取强度的比值为指标进行分析和比较.结果 AD在颞叶前部、顶叶皮层FDG摄取下降,额、顶、颞、枕叶、壳核、尾状核皮层感兴趣区与小脑皮层的FDG代谢比值分别为(0.861±0.173)、(0.625±0.149)、(0.598 ±0.185)、(0.914±0.214)、(1.030 ±0.084)、(0.997±0.102);DLB在额叶前部皮层、颞叶前部皮层、顶叶后部皮层、纹状体的FDG摄取均下降,额、顶、颞、枕叶、壳核、尾状核皮层感兴趣区与小脑皮层的FDG代谢比值分别为(0.538±0.147)、(0.615±0.138)、(0.587 ±0.142)、(0.415 ±0.107)、(0.685 ±0.094)、(0.547 ±0.103).DLB在枕叶皮层、额叶皮层、纹状体的FDG摄取下降比AD显著,差异有统计学意义(P均<0.01).结论 AD与DLB在皮层和基底节的葡萄糖代谢特征存在显著差异.这些特征有助于两者的鉴别诊断.
目的 比較阿爾茨海默病與路易體癡呆在腦葡萄糖代謝方麵的特徵.方法 本研究入選瞭28例阿爾茨海默病(AD)患者和25例路易體癡呆(DLB)患者.受試者靜脈註射示蹤刺18F脫氧葡萄糖(18F-FDG),然後接受頭部正電子髮射斷層掃描(PET).應用迭代法重建的腦圖像,分彆取額葉皮層、頂葉皮層、顳葉皮層、枕葉皮層、小腦皮層、尾狀覈頭、殼覈為感興趣區(ROI).以腦內各ROI與小腦半毬ROI的FDG攝取彊度的比值為指標進行分析和比較.結果 AD在顳葉前部、頂葉皮層FDG攝取下降,額、頂、顳、枕葉、殼覈、尾狀覈皮層感興趣區與小腦皮層的FDG代謝比值分彆為(0.861±0.173)、(0.625±0.149)、(0.598 ±0.185)、(0.914±0.214)、(1.030 ±0.084)、(0.997±0.102);DLB在額葉前部皮層、顳葉前部皮層、頂葉後部皮層、紋狀體的FDG攝取均下降,額、頂、顳、枕葉、殼覈、尾狀覈皮層感興趣區與小腦皮層的FDG代謝比值分彆為(0.538±0.147)、(0.615±0.138)、(0.587 ±0.142)、(0.415 ±0.107)、(0.685 ±0.094)、(0.547 ±0.103).DLB在枕葉皮層、額葉皮層、紋狀體的FDG攝取下降比AD顯著,差異有統計學意義(P均<0.01).結論 AD與DLB在皮層和基底節的葡萄糖代謝特徵存在顯著差異.這些特徵有助于兩者的鑒彆診斷.
목적 비교아이자해묵병여로역체치태재뇌포도당대사방면적특정.방법 본연구입선료28례아이자해묵병(AD)환자화25례로역체치태(DLB)환자.수시자정맥주사시종자18F탈양포도당(18F-FDG),연후접수두부정전자발사단층소묘(PET).응용질대법중건적뇌도상,분별취액협피층、정협피층、섭협피층、침협피층、소뇌피층、미상핵두、각핵위감흥취구(ROI).이뇌내각ROI여소뇌반구ROI적FDG섭취강도적비치위지표진행분석화비교.결과 AD재섭협전부、정협피층FDG섭취하강,액、정、섭、침협、각핵、미상핵피층감흥취구여소뇌피층적FDG대사비치분별위(0.861±0.173)、(0.625±0.149)、(0.598 ±0.185)、(0.914±0.214)、(1.030 ±0.084)、(0.997±0.102);DLB재액협전부피층、섭협전부피층、정협후부피층、문상체적FDG섭취균하강,액、정、섭、침협、각핵、미상핵피층감흥취구여소뇌피층적FDG대사비치분별위(0.538±0.147)、(0.615±0.138)、(0.587 ±0.142)、(0.415 ±0.107)、(0.685 ±0.094)、(0.547 ±0.103).DLB재침협피층、액협피층、문상체적FDG섭취하강비AD현저,차이유통계학의의(P균<0.01).결론 AD여DLB재피층화기저절적포도당대사특정존재현저차이.저사특정유조우량자적감별진단.
Objective To investigate the feature of cerebral glucose metabolism of Alzheimer's disease (AD)and dementia with lewy bodies (DLB).Methods 28 patients with AD and 25 patients with DLB underwent positron emission tomography (PET)with 18 F-fluorodeoxyglucose (18F-FDG)showing glucose metabolism.The region of interest (ROI)was selected from frontal cortex,temporal cortex,parietal cortex,occipital cortex,cerebellum cortex and corpora striata.The 18 F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results The FDG metabolism ratio of parietal cortex and temporal cortex decreased similarly in AD.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and caudate nucleus in AD was [(0.861 ± 0.173),(0.625 ± 0.149),(0.598 ± 0.185 ),(0.914 ± 0.214),( 1.030 ± 0.084)and ( 0.997 ± 0.102 )].The FDG metabolism ratio of frontal cortex,parietal cortex,occipital cortex,temporal cortex and corpus striatum decreased similarly in DLB.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and candate nucleus in DLB was [ (0.538 ±0.147),(0.615 ±0.138),( 0.587 ±0.142),(0.415 ±0.107 ),(0.685 ± 0.094)and (0.547 ± 0.103 )].The FDG metabolism ratio of frontal cortex,occipital cortex and corpus striatum decreased more significantly in DLB than in AD (P<0.01 ).Conclusion There are discrepancies in cerebral glucose metabolism between AD and DLB.These features may be useful in differential diagnosis of these two kinds of dementia.