视觉定性评估法与半定量分析法在^(18)F-florbetabenβ-淀粉样蛋白显像中的准确性比较  

Comparative analysis of the accuracy of visual qualitative assessment and semi-quantitative analysis in ^(18)F-florbetaben β-amyloid imaging

作　　者：常燕 杨晖[1] 姚树林[1] 徐白萱[1] 王瑞民[1] 张锦明[1] Chang Yan;Yang Hui;Yao Shulin;Xu Baixuan;Wang Ruimin;Zhang Jinming(Department of Nuclear Medicine,the First Medical Centre,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心核医学科,北京100853

出　　处：《中华核医学与分子影像杂志》2021年第1期23-27,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(11975249);国家科技重大专项(2014ZX09507007)。

摘　　要：目的比较视觉定性评估法和半定量分析法用于^(18)F-氟比他班(FBB)β-淀粉样蛋白(Aβ)显像诊断阿尔茨海默病(AD)的准确性并探讨其临床应用价值。方法前瞻性纳入2019年1月至2019年10月间解放军总医院临床诊断为可能的轻/中度AD患者17例[男8例,女9例,年龄(74.1±8.5)岁]和认知功能正常志愿者(NC)17名[男9名,女8名,年龄(64.5±6.3)岁]。所有受试者均行动态^(18)F-FBB PET/CT脑显像。采用视觉定性评估法和半定量分析法分析PET脑显像结果。采用两样本t检验比较2种方法所得标准摄取值比值(SUVR)差异;2种方法与临床结果的一致性采用Kappa检验分析;采用受试者工作特征(ROC)曲线确定诊断AD的SUVR最佳界值。结果视觉定性评估诊断AD的灵敏度、特异性和准确性分别为14/17、16/17和88.2%(30/34)。NC组和AD组全脑SUVR分别为1.09±0.85和1.75±0.25,复合皮质SUVR分别为1.16±0.57和1.89±0.15,差异均有统计学意义(t值:-10.263和-10.789,均P<0.001)。半定量分析法诊断AD的SUVR最佳界值为1.47,灵敏度、特异性和准确性分别为15/17、16/17和91.2%(31/34)。视觉定性评估法和半定量分析法与临床诊断结果的一致性都较好(Kappa值:0.765和0.824,均P<0.001)。结论视觉定性评估法和半定量分析法用于^(18)F-FBB Aβ显像诊断AD都具有较高的准确性,但视觉定性评估法简洁清晰易掌握,在临床工作中值得进一步推广和使用。Objective To compare the accuracy of visual qualitative assessment and semi-quantitative analysis for ^(18)F-florbetaben(^(18)F-FBB)β-amyloid(Aβ)imaging in the diagnosis of Alzheimer′s disease(AD)and to explore their clinical application value.Methods From January 2019 to October 2019,17 patients(8 males,9 females,age(74.1±8.5)years)with mild/moderate-stage clinically probable AD and 17 cognitive normal control(NC;9 males,8 females,age(64.5±6.3)years)were prospectively enrolled in this study.All patients underwent dynamic ^(18)F-FBB PET/CT brain imaging in the Chinese PLA General Hospital.Visual qualitative assessment and semi-quantitative analysis methods were used to analyze PET brain imaging results.The difference of standardized uptake value ratio(SUVR)between the two methods was analyzed by using independent sample t test.The consistency of the two methods and clinical results was analyzed by Kappa test.The cut-off value of SUVR for the diagnosis of AD was determined by receiver operating characteristic(ROC)curve.Results The sensitivity,specificity and accuracy of visual qualitative assessment to diagnose AD were 14/17,16/17 and 88.2%(30/34).The global SUVR of NC and AD group were 1.09±0.85 and 1.75±0.25(t=-10.263,P<0.001),and the composite SUVR were 1.16±0.57 and 1.89±0.15(t=-10.789,P<0.001),respectively.The cut-off value of SUVR for the diagnosis of AD was 1.47,with the sensitivity of 15/17,the specificity of 16/17 and the accuracy of 91.2%(31/34).The visual qualitative assessment and semi-quantitative analysis had good consistency with clinical diagnosis results with Kappa value of 0.765 and 0.824 respectively(both P<0.001).Conclusion The visual qualitative assessment and semi-quantitative analysis methods used in ^(18)F-FBB Aβimaging to diagnose AD patients show high accuracy and can provide effective value for clinical diagnosis,but the visual qualitative assessment method is concise and easy to grasp,which is worth further promotion and use in clinical.

关 键 词：阿尔茨海默病 淀粉样蛋白 二苯乙烯类 正电子发射断层显像术 

分 类 号：R749.16[医药卫生—神经病学与精神病学]