一体化PET/MR结合统计参数图辅助^11C-PIB显像的半定量分析及其临床应用  

Study of statistical parametric mapping aided semi-quantitative analysis of 11C-PIB PET imaging acquired by hybrid PET/MR and its clinical application

作　　者：孙逊[1] 阮伟伟 黄小娟 刘芳[1] 扈雪晗 盖永康 柳轻瑶[1] 兰晓莉[1] Sun Xun;Ruan Weiwei;Huang Xiaojuan;Liu Fang;Hu Xuehan;Gai Yongkang;Liu Qingyao;Lan Xiaoli(Department of Nuclear Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology/Hubei Province Key Laboratory of Molecular Imaging,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院核医学科、分子影像湖北省重点实验室,武汉430022

出　　处：《中华核医学与分子影像杂志》2020年第4期207-212,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(81701759);湖北省技术创新重大项目(2017ACA182)。

摘　　要：目的 研究一体化PET/MR结合统计参数图(SPM)辅助^11C-匹兹堡化合物B(PIB)用于β-淀粉样蛋白(Aβ)PET显像半定量分析的准确性,探索其用于认知障碍的诊断及鉴别诊断的可行性.方法 回顾分析2018年1月至2019年9月在华中科技大学同济医学院附属协和医院PET中心进行^11C-PIB PET/MR扫描,临床最终确诊的13例阿尔茨海默病(AD)患者[男4例,女9例;年龄(59.2±5.8)岁]和10例血管性认知障碍(VCD)患者[男9例,女1例;年龄(59.5±11.5)岁].结合三维T1加权成像(3D T1WI)对^11C-PIB PET图像分别进行脑区手动勾画和SPM辅助半自动分割,获得8个关键脑区(大脑白质、纹状体、丘脑、后扣带回、额叶皮质、后顶叶皮质、颞叶外侧皮质和枕叶皮质)与小脑皮质的标准摄取值比值(SUVR).对2种方法所获结果进行Pearson相关分析;采用两独立样本t检验、配对t检验分析数据.结果 AD组与VCD组患者的年龄和简易精神状态检查量表(MMSE)评分[(19.7±4.7)和(21.7±3.8)分]差异均无统计学意义(t值:0.095和1.098,均P>0.05).除丘脑外(r=0.179,P=0.413),分割法和勾画法在其余7个关键脑区获得的SUVR均有良好的相关性(r值:0.678~0.893,均P<0.05).AD组8个关键脑区的SUVR均明显高于VCD组(1.519~2.055与1.105~1.618;t值:2.799~11.582,均P<O.01).分割法所得AD组纹状体(1.942±0.205)、后扣带回(1.915±0.249)、额叶(1.983±0.264)、顶叶(2.008±0.296)及颞叶皮质(1.931±0.254) SUVR均明显高于大脑白质(1.746±0.192;t值:3.793~6.992,均P<0.01),而VCD组中无一关键脑区明显高于大脑白质.结论 一体化PET/MR同步采集结合SPM辅助可实现脑区准确分割并获得关键脑区的半定量数据,可用于分析AD和VCD的^11C-PIB Aβ显像特点和差异,有望为认知障碍的诊断和鉴别诊断提供精准的影像学分析方法.Objective To explore the feasibility of statistical parametric mapping(SPM)aided semi-quantitative analysis in ^11C-Pittsburgh compound B(PIB)β-amyloid(Aβ)PET imaging acquired by hybrid PET/MR,and evaluate its possibility in assisting the diagnosis or differential diagnosis for cognitive impairment.Methods From January 2018 to September 2019,13 Alzheimer′s disease(AD)patients(4 males,9 females;age(59.2±5.8)years)and 10 vascular cognitive disorders(VCD)patients(9 males,1 female;age(59.5±11.5)years)who underwent ^11C-PIB PET/MR in PET center of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology were retrospectively analyzed.The standardized uptake value ratio(SUVR)of eight key brain regions(cerebral white matter,striatum,thalamus,posterior cingulate gyrus,frontal cortex,posterior parietal cortex,lateral temporal cortex and occipital cortex)to cerebellum cortex were obtained by manual delineation and SPM-aided semi-automatic segmentation with the help of synchronous three-dimensional T1 weighted imaging(3D T1WI).Pearson correlation analysis was carried out on the SUVR obtained by the two methods.Independent-sample t test and paired t test were used to analyze the data.Results There was no significant difference between AD group and VCD group in age and Mini-Mental State Examination(MMSE)score(19.7±4.7 vs 21.7±3.8;t values:0.095 and 1.098,both P>0.05).Except thalamus(r=0.179,P=0.413),there were good correlations between SUVR obtained by segmentation and delineation in the other 7 key regions(r values:0.678-0.893,all P<0.05).The SUVR of 8 key regions obtained by the two methods in AD group was significantly higher than that in VCD group(1.519-2.055 vs 1.105-1.618;t values:2.799-11.582,all P<0.01).The SUVR of striatum(1.942±0.205),posterior cingulate gyrus(1.915±0.249),frontal lobe(1.983±0.264),parietal lobe(2.008±0.296)and temporal cortex(1.931±0.254)in AD group was significantly higher than that of cerebral white matter(1.746±0.192;t values:3.793-6.992,all P<0.01).But in

关 键 词：阿尔茨海默病 认知障碍 淀粉样蛋白 正电子发射断层显像术 磁共振成像 

分 类 号：R74[医药卫生—神经病学与精神病学]