^(18)F-D3FSP PET/CT在不同程度认知障碍患者中的应用价值  

Application value of ^(18)F-D3FSP PET/CT in patients with cognitive impairment of varying degrees

作　　者：梁思浩 李安琪 赵睿玥 李靖雯 侯鹏[1] 熊爽 吴卓华[3] 陈祥 黄玉英 郭腾飞 王欣璐 Liang Sihao;Li Anqi;Zhao Ruiyue;Li Jingwen;Hou Peng;Xiong Shuang;Wu Zhuohua;Chen Xiang;Huang Yuying;Guo Tengfei;Wang Xinlu(Department of Nuclear Medicine,the First Affiliated Hospital,Guangzhou Medical University,Guangzhou 510120,China;Institute of Biomedical Engineering,Shenzhen Bay Laboratory,Shenzhen 518132,China;Department of Neurology,the First Affiliated Hospital,Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院核医学科,广州510120 [2]深圳湾实验室生物医学工程研究所,深圳518132 [3]广州医科大学附属第一医院神经内科,广州510120

出　　处：《中华核医学与分子影像杂志》2024年第5期260-265,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^(18)F-氘代氟贝他吡(D3FSP)PET/CT显像探测不同程度认知障碍患者大脑内β-淀粉样蛋白(Aβ)沉积的有效性,以及其与血浆生物标志物的相关性。方法回顾性分析2022年6月至2023年11月基于大湾区健康衰老脑纵向队列研究(GHABS)在广州医科大学附属第一医院完成^(18)F-D3FSP PET/CT显像的患者79例[男32例、女47例,年龄(66±7)岁],按照阿尔茨海默病(AD)神经影像学倡议标准方案分为认知未受损(CU)、轻度认知障碍(MCI)和AD组,采用AW工作站分割脑区并以小脑为参考脑区计算SUV比值(SUVR),用单因素方差分析、Bonferroni法校正及Pearson相关分析比较数据。采用ROC曲线分析获得SUVR最佳界值及诊断效能。结果CU、MCI和AD组分别有48、15和16例,随着从CU到MCI再到AD的过渡,全脑及各脑区(双侧额叶、双侧前扣带回、双侧楔前叶、双侧顶叶、双侧外侧颞叶、双侧枕叶)SUVR呈上升趋势(F值:11.15~22.38,均P<0.001),右侧前扣带回、双侧楔前叶SUVR在CU与MCI组间存在差异(均P<0.017),双侧额叶、右侧楔前叶、双侧顶叶、双侧外侧颞叶、双侧枕叶SUVR在MCI与AD组间差异有统计学意义(均P<0.017)。各脑区SUVR与认知量表评分呈负相关(r值:-0.57~-0.37,均P<0.001),与血浆磷酸化tau181(p-tau181)呈正相关(r值:0.50~0.61,均P<0.001)。ROC曲线示楔前叶SUVR鉴别CU组与AD组的最佳界值为1.20,其AUC为0.85,灵敏度、特异性、准确性分别为12/16、91.7%(44/48)、87.5%(56/64)。结论^(18)F-D3FSP PET/CT显像在评估Aβ脑内沉积部位和程度中具有良好的临床应用价值,并与临床认知及血浆p-tau181水平相关。Objective To explore the effectiveness of^(18)F-deuterated-Florbetapir(D3FSP)PET/CT imaging in detectingβ-amyloid(Aβ)deposition in the brain and its correlation with plasma biomarkers.Methods A retrospective analysis was conducted on 79 patients(32 males,47 females;age(66±7)years)who underwent^(18)F-D3FSP PET/CT imaging from June 2022 to November 2023 at the First Affiliated Hospital,Guangzhou Medical University,as a part of the Greater Bay Area Healthy Aging Brain Longitudinal Cohort Study(GHABS).Based on the Alzheimer′s Disease Neuroimaging Initiative cohort standard protocol,patients were categorized into cognitively unimpaired(CU)group,mild cognitive impairment(MCI)group,and Alzheimer′s disease(AD)group.Brain regions were segmented using the AW workstation and the SUV ratio(SUVR)was calculated with the cerebellum as the reference region.One-way analysis of variance,Bonferroni correction and Pearson correlation analysis were used to analyze data.The ROC curve analysis was used to analyze the cut-off value and the diagnostic efficacy of SUVR.Results There were 48,15 and 16 cases in CU,MCI and AD groups respectively.During the transition from CU to MCI and then to AD,there was a rising trend in SUVR(F values:11.15-22.38,all P<0.001)across the whole brain and various brain regions(bilateral frontal lobes,bilateral anterior cingulate gyrus,bilateral precuneus,bilateral parietal lobes,bilateral lateral temporal lobes,and bilateral occipital lobes).SUVRs of the right anterior cingulate gyrus and bilateral precuneus were different between the CU and MCI groups(all P<0.017),and those of bilateral frontal lobes,right precuneus,bilateral parietal lobes,bilateral lateral temporal lobes,and bilateral occipital lobes were different between the MCI and AD groups(all P<0.017).SUVRs of brain regions were negatively correlated with cognitive scale scores(r values:from-0.57 to-0.37,all P<0.001),and were positively correlated with plasma phosphorylated tau181(p-tau181,r values:0.50-0.61,all P<0.001).The ROC curve analysis

关 键 词：阿尔茨海默病 认知功能障碍 淀粉样β肽类 吡啶类 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R749[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]