多模态分子影像学在路易体痴呆诊断中的应用  

The application of multimodal molecular imaging in the diagnosis of dementia with Lewy bodies

作　　者：高中宝[1] 王炜[1] 陈彤[1] 富丽萍[2] 徐白萱[2] 王振福[1] 

机构地区：[1]解放军总医院南楼神经科,北京100853 [2]解放军总医院核医学科,北京100853

出　　处：《中国现代神经疾病杂志》2017年第1期46-52,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：北京市科技计划项目(项目编号:Z151100004015206);中央保健科研课题(项目编号:W2013BJ14);解放军总医院临床扶持基金资助项目(项目编号:2015FC-TSYS-1016);解放军总医院医疗大数据研发项目(项目编号:2016MBD-020)~~

摘　　要：目的探讨多模态分子影像学技术在路易体痴呆诊断中的应用价值。方法共5例可能的路易体痴呆患者,进行详细的临床病史采集、神经心理学测验、头部MRI检查,以及^(11)C-甲基-N-2β-甲基酯-3β-(4-氟苯基)托烷(^(11)C-β-CFT)、11C-匹兹堡复合物B(^(11)C-PIB)和18F-脱氧葡萄糖(^(18)F-FDG)PET显像。结果路易体痴呆患者早期认知功能障碍和幻视较为明显。^(11)C-β-CFT PET可见双侧壳核和尾状核多巴胺转运体摄取降低;^(11)C-PIB PET可见双侧额颞顶枕叶皮质弥漫性淀粉样蛋白摄取升高;^(18)F-FDG PET可见双侧顶枕叶葡萄糖代谢降低。结论多模态分子影像学技术可以显著提高路易体痴呆临床诊断的特异性,有望实现生前明确诊断。Objective To evaluate the value of multimodal molecular imaging in the diagnosis of dementia with Lewy bodies （DLB）. Methods Five patients with probable DLB received detailed clinical data collection, neuropsychological tests, head MRI examination, 11C - methyl- N - 2β - earbomethoxy- 3 β - （4 - fluorophenyl）-tropane （11C-β-CFT） PET, 11C-Pittsburgh compound B （11C-PIB） PET and 18F-fluoro-2-deoxy-D- glucose （LSF- FDG） PET examination. Results Cognitive dysfunction and visual hallucinations were prominent symptoms in patients with DLB. 11C-β-CFT PET showed that the radioactive uptake significantly reduced in bilateral putamen and eaudate nuclei, 11C-PIB PET showed increased radioactive retention in bilateral frontal, temporal, parietal and occipital cortex with various degrees. 18F-FDG PET showed glucose hypometabolism in bilateral parietal and occipital cortex. Conclusions Muhimodal molecular imaging greatly improves the specificity of clinical diagnosis of DLB, and it is expected to achieve accurate diagnosis before death.

关 键 词：LEWY体病 痴呆 正电子发射断层显像术 

分 类 号：R749.1[医药卫生—神经病学与精神病学]