阿尔茨海默病葡萄糖代谢与淀粉样蛋白正电子发射断层显像成像特点  

Characteristics of glucose metabolism and amyloid deposition by positron emission tomography images in Alzheimer＇s disease

作　　者：纪勇[1] 石志鸿[1] 蔡莉[3] 刘帅[1] 韩彤[2] 王颖[3] 刘淑玲[1] 韩景献[4] 周玉颖[1] 王新平[1] 邢永红[1] 高硕[3] 

机构地区：[1]天津市环湖医院神经内科,300060 [2]天津市环湖医院影像科,300060 [3]天津医科大学总医院核医学科 [4]天津中医药大学第一附属医院

出　　处：《中华老年医学杂志》2013年第9期940-944,共5页Chinese Journal of Geriatrics

基　　金：天津市科委科技支撑计划重点项目基金（12ZCZDSY02900）;天津市卫生局攻关项目基金（11KG117）

摘　　要：目的利用^18F-脱氧葡萄糖（FDG）及^11C-匹兹堡化合物B（PIB）显像探讨阿尔茨海默病（AD）的正电子发射断层显像（PET）影像学特点。方法轻度、中度AI）各6例患者行神经心理学量表评定及头颅核磁共振（MRI）扫描。12例患者及6例健康对照行FDG—PET和PIB-PET脑显像。通过目测和计算机成像系统对结果进行分析。结果轻度和中度AD患者目测分析颞叶内侧萎缩、皮层萎缩、侧脑室扩大无明显差别。轻度AD患者葡萄糖代谢率减低主要部位为颞顶联合区皮层、顶下小叶、颞上回、楔前叶、后扣带回、尾状核等；中度AD患者出现额叶上中回、额下回、颞中回、前扣带回等部位代谢减低；AD患者淀粉样蛋白沉积主要部位为额叶、顶叶皮层、后扣带回、楔前叶、颞叶外侧。AD患者45min额叶、颞叶外侧、顶叶PIB放射性活性清除率较对照组明显减低，但轻度和中度AD患者PIB清除率没有明显差别。结论FDGPET功能成像反应脑部葡萄糖代谢的改变，与痴呆的程度相关，PETPIB成像能反映AD特有的病理改变，与痴呆的程度不相关，FDGPEF结合PIBPET对AD的诊断具有重要的意义。Objective To investigate positron emission tomography （PET） image characteristics of glucose metabolism and amyloid deposition as demonstrated by fluorodeoxyglucose （ ^18F FDG） and Pittsburgh Compound B （PiB） in Alzheimer＇s disease （AD）. Methods Patients with mild AD and moderate AD （n= 6, each） were included in this study. 6 healthy subjects were selected as normal controls. Cognitive function was assessed by the mini-mental state examination, montreal cognitive assessment and Clinical Dementia Rating. Ventricular dilation, cortical and hippocampal atrophy were detected by brain magnetic resonance imaging. 18 F-FDG and PIB PET cerebral images were perl＇ormed in patients and normal controls. PET images were analyzed by visual ization and computer imaging system. Results There were no significant differences in ventricular dilation, and cortical and hippocampal atrophy by visual analysis between patients with mild AD and moderate AD （all P〉 0.05）. For ^18F-FDG PET cerebral image, regional cerebral glucose metabolism （rCMRGIu） was decreased in temporal-parietal cortex, inferior parietal lobe, superior temporal gyrus, precuneus, posterior cingulate gyrus, caudate nucleus in mild AD patients, while decreased in frontal lobe gyrus, inferior frontal gyrus, middle temporal gyrus and anterior cingulate cortex in moderate AD patients. Amyloid was mainly deposited in frontal, parietal and posterior cingulate cortexes, precuneus and lateral temporal lobe in AD patients. The radioactivity clearance rate was significantly decreased in frontal, temporal and parietal lobes in AD patients as compared with normal controls 45 min after PIB injection （all P〈0.05）. There was no significant difference in radioactivity clearance rate between mild AD patients and moderate AD patients （P〉0. 05）. Conclusions FDG PET image in glucose metabolism is correlated with the severity of dementia. PIB PET image can reflect the typical pathological changes in Alzheimer＇s disease, but has no correlatio

关 键 词：阿尔茨海默病 正电子发射断层显像术 淀粉样蛋白 氟脱氧葡萄糖F1 8 

分 类 号：R749.16[医药卫生—神经病学与精神病学]