脑β-淀粉样蛋白PET显像模型分析对AD与MCI的诊断价值  

Diagnostic efficiency of Aβprotein PET brain imaging model in patients with AD and MCI

作　　者：李锦萍 伍清宇 查悦明 李建芳[1] 秦露平[1] 马晓萌[2] 万麒昌 程木华[1] Li Jinping;Wu Qingyu;Zha Yueming;Li Jianfang;Qin Luping;Ma Xiaomeng;Wan Qichang;Cheng Muhua(Department of Nuclear Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院核医学科,广州510630 [2]中山大学附属第三医院神经内科,广州510630 [3]中山大学孙逸仙纪念医院核医学科,广州510120

出　　处：《新医学》2022年第5期314-318,共5页Journal of New Medicine

基　　金：广东省自然科学基金(2017A030313682);吴阶平医学基金(320.6750.2020-06-6)。

摘　　要：目的探讨脑β-淀粉样蛋白(Aβ)PET显像模型分析对阿尔茨海默病(AD)与轻度认知功能障碍(MCI)的鉴别诊断价值。方法纳入32例认知功能障碍受试者,经临床检查明确AD或MCI诊断,对其静脉注射显像剂;F-AV-452.96~4.44 MBq/kg,行心脏和头部PET/CT扫描。测得患者左心室及脑部感兴趣区域(ROI)不同时间点的比活度拟合曲线,通过Logan模型计算;F-AV-45代谢率K值。采用Mann-Whitney U检验比较AD与MCI患者代谢率K值的差异,使用受试者工作特征(ROC)曲线评估Logan模型的诊断效能。结果AD、MCI患者大脑皮质Aβ沉积程度不同,应用Logan模型代谢率K值可鉴别两者,AD患者代谢率K值为3.96(2.66,4.26),高于MCI患者代谢率K值2.62(1.41,2.96)(P<0.05)。代谢率K值ROC曲线分析获得最佳诊断阈值为3.23,其诊断灵敏度为100%、特异度为58.33%,ROC曲线下面积为0.781(Z=-2.350、P<0.05)。结论脑AβPET显像Logan模型分析对AD与MCI具有较佳的鉴别诊断效能。Objective To evaluate the diagnostic value of Aβprotein PET brain imaging model in distinguishing patients with Alzheimer’s disease(AD)from mild cognitive impairment(MCI).Methods Thirty-two subjects with cognitive impairment were enrolled in this study.All participants were diagnosed with AD or MCI by clinical examination and underwent;F-AV-45(2.96~4.44 MBq/kg)PET/CT scan(heart and head).The fitting curves of specific activity of left ventricle and region of interest(ROI)at different time points were delineated,and then the metabolic rate K was calculated by Logan model.The difference in metabolic rate K value was compared between AD and MCI groups by using Mann-Whitney U test.The diagnostic efficiency of Logan model was evaluated by the receiver operator characteristic(ROC)curve.Results The degree of Aβprotein deposition in the cerebral cortex of AD and MCI patients was different.AD and MCI patients could be distinguished with the K value of Logan model.The K value in the AD group was 3.96(2.66,4.26),significantly higher than 2.62(1.41,2.96)in the MCI group(P<0.05).According to ROC curve analysis,the optimal diagnostic threshold of K value was 3.23,the diagnostic sensitivity was 100%,the specificity was 58.33%,and the area under ROC curve(AUC)was 0.781(Z=-2.350,P<0.05),respectively.Conclusion Aβprotein PET imaging with Logan model has high diagnostic efficacy in distinguishing AD from MCI.

关 键 词：Β-淀粉样蛋白 阿尔茨海默病 轻度认知功能障碍 PET显像 模型分析 

分 类 号：R749.16[医药卫生—神经病学与精神病学]