SPECT/CT脑血流灌注显像联合NeuroGamTM软件在主观认知下降、轻度认知障碍和阿尔兹海默病中的临床应用  

Clinical application of brain perfusion SPECT/CT imaging with NeuroGam^(TM) software in subjective cognitive decline,mild cognitive impairment and Alzheimer's disease

作　　者：雷哲 吴寒 欧颖晖 徐蒨 史昕 石珂清 赵倩华 丁晶 尹又 王修哲 刘学源[6] 楼菁菁 刘兴党 LEI Zhe;WU Han;OU Yinghui;XU Qian;SHI Xin;SHI Keqing;ZHAO Qianhua;DING Jing;YIN You;WANG Xiuzhe;LIU Xueyuan;LOU Jingjing;LIU Xingdang(Department of Nuclear Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Nuclear Medicine,Fudan University Pudong Medical Center,Shanghai 201399,China;Department of Neurology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Neurology,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China;Department of Neurology,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai 200233,China;Department of Neurology,the Tenth People's Hospital Affiliated to Tongji University,Shanghai 200072,China)

机构地区：[1]复旦大学附属华山医院核医学科,上海200040 [2]复旦大学附属浦东医院核医学科,上海201399 [3]复旦大学附属中山医院神经内科,上海200032 [4]海军军医大学附属长征医院神经内科,上海200003 [5]上海交通大学附属第六人民医院神经内科,上海200233 [6]同济大学附属第十人民医院神经内科,上海200072

出　　处：《核技术》2022年第2期32-38,共7页Nuclear Techniques

基　　金：上海市"科技创新行动计划"临床医学领域重大研究计划(No.17411950102);国家重点研发计划"数字诊疗装备研发"重点专项(No.2017YFC0113300);浦东新区临床特色学科(No.PWYts2021-01);复旦大学附属浦东医院科研启动金项目计划(No.YJYJRC202108/YJYJRC202101/Zdzk2020-14)资助。

摘　　要：本文拟探讨主观认知下降(Subjective Cognitive Decline,SCD)、轻度认知障碍(Mild Cognitive Impairment,MCI)及阿尔兹海默病(Alzheimer's Disease,AD)的脑血流灌注差异,并评估SPECT/CT脑血流灌注显像联合NeuroGam^(TM)软件在这三种疾病中的应用价值。从2020年7月至2021年4月,从上海多家综合性医院收集15名SCD患者、29名MCI患者及36名AD患者,所有受试者行神经心理测试和99m锝-双半胱乙酯(^(99m)TcECD)SPECT/CT脑血流灌注显像。应用自动化软件NeuroGam^(TM)对三组各Brodmann分区(Brodmann Areas,BA)的灌注水平进行半定量分析,并与正常数据库进行比较。采用独立样本t检验、单因素方差分析、秩和检验分析定量资料组间差异;采用Pearson卡方检验进行定性资料组间差异比较。SCD组和MCI组在BA 4~11,17~25,28,31~32,36~40及44~47的血流灌注水平均无显著差异。SCD组在BA 8-right(R)、20-left(L)、21R、23L、23R、24L、31L、38L、38R、45R的平均灌注值显著高于AD组(p<0.0167)。MCI组在BA 21R、23L、23R、31L、39L的平均灌注值显著高于AD组(p<0.0167)。与正常数据库相比,SCD组BA 24L、24R、28L、28R灌注水平减低;MCI组BA 21L、21R、23R、24L、24R、25L、25R、28L、28R、36L、36R、38R、47L灌注水平减低,AD组BA 21L、21R、22L、23L、23R、24L、24R、25R、28L、28R、32L、32R、36L、36R、47L灌注水平减低。SCD、MCI、AD脑血流灌注减低的程度和范围存在差异,SPECT/CT脑血流灌注显像联合NeuroGam^(TM)软件在这三种疾病中有一定的应用价值,可作为辅助诊断工具。[Background]Subjective cognitive decline(SCD)and mild cognitive impairment(MCI)are a transitional state between normal aging and mild dementia,and most of them have potential Alzheimer's Disease(AD)pathology.Studying the pathophysiological characteristics of SCD and MCI is helpful to the early diagnosis of AD.[Purpose]This study aims to investigate the brain perfusion differences among SCD,MCI and AD,and to evaluate the application value of brain perfusion SPECT/CT imaging combined with NeuroGam^(TM) software in these diseases.[Methods]From July 2020 to April 2021,15 patients with SCD,29 patients with MCI and 36 patients with AD were collected from several general hospitals in Shanghai.All subjects underwent neuropsychological test and ^(99m)Tc-ECD brain perfusion SPECT/CT imaging.The perfusion levels of Brodmann areas(BA)in the three groups were semi-quantitatively analyzed by NeuroGam^(TM),and compared with normal database.Student's t-test,one-way analysis of variance and rank sum test were used for the comparison of quantitative variables.Pearson's chi-squared test was used for the comparison of qualitative variables.[Results]There is no significant difference in BA 4~11,17~25,28,31~32,36~40 and 44~47 between SCD group and MCI group.The mean perfusion values of BA 8-right(R),20-left(L),21R,23L,23R,24L,31L,38L,38R and 45R in SCD group are significantly higher than those in AD group(p<0.0167).The mean perfusion values of BA 21R,23R,23R,31L and 39L of MCI group are significantly higher than those in AD group(p<0.0167).Compared with the normal database,SCD group show hypoperfusion in BA 24L,24R,28L and 28R whilst MCI group show hypoperfusion in BA 21L,21R,23R,24L,24R,25L,25R,28L,28R,36L,36R,38R and 47L,and AD group show hypoperfusion in BA 21L,21R,22L,23L,23R,24L,24R,25R,28L,28R,32L,32R,36L,36R,47L.[Conclusions]There are differences in the degree and range of hypoperfusion in SCD,MCI and AD.Brain perfusion SPECT/CT imaging combined with NeuroGam^(TM) software has certain application value in these diseases and can

关 键 词：阿尔兹海默病 轻度认知障碍 主观认知下降 脑血流灌注 单光子发射计算机断层扫描 

分 类 号：R817.4[医药卫生—影像医学与核医学]