帕金森病认知功能障碍的^18F—FDGPET／CT研究  

Evaluation of metabolic changes in Parkinson＇s disease patients with different severities of cognitive impairments by ^18F-FDG PET/CT brain imaging

作　　者：浦兰兰 解敬慧[2] 冯洪波[2] 刘美辰[1] 张延军[2] 梁战华[1] 

机构地区：[1]大连医科大学附属第一医院神经内科,116011 [2]大连医科大学附属第一医院核医学科,116011

出　　处：《中华核医学与分子影像杂志》2016年第2期146-150,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 利用^18F-FDG PET/CT研究PD认知功能障碍（PD-CI）患者的脑葡萄糖代谢特点，分析PD-CI的进展过程及认知功能变化与脑代谢显像的相关性。方法 将2013年5月至2014年2月31例（男14例，女17例，年龄37～77岁）原发性PD患者，按蒙特利尔认知评估量表（MOCA）分为无认知功能障碍（PD-NC）组（MOCA评分〉26分）、轻度认知功能障碍（PD-MCI）组（MOCA评分21～26分）和痴呆（PDD）组（MOCA分〈21分），同时以12名（男7名，女5名，年龄40～76岁）年龄、性别匹配的健康体检者作为健康对照（NC）组，进行前瞻性研究。受检者按体质量静脉注射5.55 MBq/kg的18F-FDG后行PET/CT显像，采用MIMneuro软件分析图像，比较各组间脑代谢及认知功能的差异和相关性。采用Pearson和Spearson相关分析数据间相关性。结果 （1）PD各组与NC组比较：PDD组与NC组相比出现广泛皮质代谢减低；PD-MCI组与NC组相比在枕叶、顶叶等后部皮质出现代谢减低，额叶、颞叶也有部分区域代谢减低；PD-NC组与NC组相比脑代谢未见明显减低。（2）PD各组间脑代谢比较：相比于PD-NC组，PDD组在枕叶广泛皮质、颞叶、部分顶叶及后扣带回出现代谢减低；相比于PD-MCI组，PDD组在后部皮质中的枕叶、颞叶和顶叶出现代谢减低；相比于PD-NC组，PD-MCI组在右侧缘上回及左侧海马旁回出现代谢减低。（3）PD-CI患者脑代谢与认知功能相关性分析：视空间与执行功能与视觉皮质区、角回、顶上小叶代谢均成正相关（r＝0.535、0.443和0.395，均P〈0.05），延迟回忆与颞横回代谢成正相关（r＝0.337，P〈0.05）。结论 ^18F-FDG PET/CT显像能客观反映PD-CI的进展过程，由其测得的脑代谢改变同MOCA量表的评估结果间具有良好的相关性。Objective To investigate the characteristics of cerebral glucose metabolism （CGM） in PD patients with cognitive impairment （PD-CI） using ^18F-FDG PET/CT, and to analyze the correlation between the progress of PD-CI and CGM changes. Methods A total of 31 idiopathic PD patients （14 males, 17 females, aged 37-77 years） from May 2013 to February 2014 were divided into 3 groups based on Montreal cognitive assessment （MOCA）： none CI in PD （PD-NC） group （MOCA〉26 scores）, mild CI in PD （PD-MCI） group （MOCA 21-26 scores）, PD with dementia （PDD） group （MOCA〈21 scores）. The normal controls （NC） group included 12 age- and gender-matched healthy adults （7 males, 5 females, aged 40-76 years）. All subjects underwent PET/CT imaging after intravenous injection of ^18F-FDG（5.55 MBq/kg）. MIMneuro software was used to analyze the data. The correlation between the CGM and cognitive function was analyzed using Pearson or Spearman correlation analysis.Results （1） Compared with NC group, PDD group presented a widespread cortical metabolism decrease in frontal, parietal, temporal, occipital lobes and the limbic lobe; PD-MCI group showed hypometabolic areas in the parietal and occipital lobes, and with less extent in the frontal and temporal lobes; PD-NC group showed no significant cerebral hypometabolism. （2） Compared with PD-NC group, PDD group showed widespread cortical metabolism decrease in occipital lobe, temporal lobe, partial parietal cortex and the posterior cingulated cortex. Compared with PD-MCI group, PDD group had lower metabolism, mainly in posterior brain areas （parietal, occipital and temporal lobes）. Compared with PD-NC group, PD-MCI group showed hypometabolism in right supramarginal gyrus and the left parahippocampal gyrus. （3） There were positive correlations between visuospatial/executive function and visual cortex metabolism, angular gyrus metabolism or superior parietal lobule metabolism （r=0.535, 0.443, 0.395; all P〈0.05）. A positive cor

关 键 词：帕金森病 认知障碍 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]