慢性意识障碍患者PET显像的预后评价研究  

The role of PET imaging in the evaluation of prognosis in patients with chronic disorders of consciousness

作　　者：张静[1] 全志永[2] 康晓刚[1] 高琼[1] 江文[1] 

机构地区：[1]第四军医大学西京医院神经内科,西安710032 [2]第四军医大学西京医院核医学科,西安710032

出　　处：《中国现代神经疾病杂志》2015年第12期940-943,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：第四军医大学西京医院学科助推计划(项目编号:XJZT09Z07)~~

摘　　要：目的探讨18F-脱氧葡萄糖(18F-FDG)PET显像对慢性意识障碍患者预后的评价作用。方法采用18F-FDG PET观察20例慢性意识障碍患者(包括无反应觉醒综合征/植物状态12例、最低意识状态8例)大脑外在和内在感知网络区域葡萄糖代谢变化,计算各区域标准化摄取值(SUV);并比较随访6个月时意识恢复[Glasgow预后分级-扩展版(GOS-E)>2级]与意识未恢复(GOS-E分级≤2级)患者各区域的葡萄糖摄取情况。结果 20例患者6个月随访时失访1例、死亡9例、意识未恢复2例、意识恢复8例。意识未恢复组(意识未恢复+死亡)患者年龄高于意识恢复组(P=0.001);而昏迷恢复量表-修订版(CRS-R)评分(P=0.030),以及双侧前额叶(左侧P=0.000,右侧P=0.002)、顶叶(左侧P=0.003,右侧P=0.007)、楔前叶(左侧P=0.000,右侧P=0.003)、前扣带回(P=0.001)、后扣带回(P=0.006)SUV值均低于意识恢复组。结论18F-FDG PET显像所示外在和内在感知网络区域葡萄糖代谢变化与慢性意识障碍患者预后相关,SUV值越高、预后越佳。ObjectiveTo explore the role of18F-fluoro-2-deoxy-D-glucose（18F-FDG） PET imagingfor evaluation of the prognosis of patients with chronic disorders of consciousness.Methods18F-FDG PETwas performed to analyze glucose metabolism of external and internal awareness networks in 20 patientswith chronic disorders of consciousness, and to calculate standardized uptake value（SUV） of each region.Compare the SUV of each region between conscious [Glasgow Outcome Scale- Extended（GOS- E） 2] andunconscious（GOS-E ≤ 2） patients after 6 months follow-up.ResultsAfter 6 months, one case was lost,8 cases recovered consciousness during the follow-up, 11 were unconscious（2 cases） or dead（9 cases）. Theage of unconscious or dead patients was significantly higher than that of conscious（P = 0.001）, while theComa Recovery Scale-Revised（CRS-R） score（P = 0.030） and the SUV of bilateral prefrontal lobes（left P =0.000, right P = 0.002）, bilateral parietal lobes（left P = 0.003, right P = 0.007）, bilateral precuneus（left P =0.000, right P = 0.003）, anterior（P = 0.001） and posterior（P = 0.006） cingulate cortices of unconscious ordead patients were significantly lower than that of conscious patients.ConclusionsThe SUV of externaland internal awareness networks in18F-FDG PET imaging is related to the prognosis of patients with chronicdisorders of consciousness. The higher the SUV is, the better prognosis will be achieved.

关 键 词：意识障碍 正电子发射断层显像术 预后 

分 类 号：R741[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]