^(18)F-PI-2620 PET脑显像对不同认知障碍患者tau蛋白的辅助诊断价值及认知相关分析  

Significance of ^(18)F-PI-2620 PET imaging for diagnosing tau protein deposition in patients with different cognitive disorders alongside cognitive correlation analysis

作　　者：黄干 张焱 王成[1] 辛玫[1] 邵泓达 王悦[1] 万良荣[1] 邱菊 徐群[2] 刘建军[1] 李霞[3] 张晨鹏[1] Huang Gan;Zhang Yan;Wang Cheng;Xin Mei;Shao Hongda;Wang Yue;Wan Liangrong;Qiu Ju;Xu Qun;Liu Jianjun;Li Xia;Zhang Chenpeng(Department of Nuclear Medicine,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Neurology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Geriatric Psychiatry,Shanghai Mental Health Center,School of Medicine,Shanghai Jiao Tong University)

机构地区：[1]上海交通大学医学院附属仁济医院核医学科,上海200127 [2]上海交通大学医学院附属仁济医院神经内科,上海200127 [3]上海交通大学医学院附属精神卫生中心老年精神科、上海交通大学阿尔茨海默病诊治中心,上海200030

出　　处：《中华核医学与分子影像杂志》2024年第5期273-278,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家重点研发计划(2023YFC3603200)。

摘　　要：目的探讨^(18)F-PI-2620 PET/CT脑显像中SUV比值(SUVR)对不同认知障碍患者大脑内tau蛋白沉积模式的评估价值及其与认知的相关性。方法本研究为横断面研究。回顾性纳入仁济医院2019年12月至2022年11月间67例受试者,包括54例阿尔茨海默病(AD)患者[男21例、女33例,年龄(68.6±7.8)岁]、7例轻度认知障碍(MCI)患者[男1例、女6例,年龄(63.1±11.2)岁]和6名健康对照(HC)[男4名、女2名,年龄(69.0±5.8)岁]。对所有纳入者行^(18)F-PI-2620 PET/CT检查,以小脑下部为参考脑区,获得额叶、颞叶、枕叶、顶叶、岛叶、全脑以及10个独立感兴趣脑区(杏仁核、眶额叶皮质、扣带回、枕上回、顶上回、顶下缘角回、楔前叶、颞下回、内嗅皮质和海马旁回)SUVR。检查前所有受试者行神经心理学认知量表评估[简易精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)]。采用单因素方差分析和最小显著差异t检验分析3组受试者SUVR的差异;通过ROC曲线分析获得各脑区SUVR鉴别AD-MCI和AD-NC的最佳界值;采用Pearson相关分析探讨SUVR与认知量表评分的相关性。结果AD组、MCI组和HC组的全脑SUVR分别为1.40±0.31、1.08±0.19和1.01±0.12。全脑和不同脑区分割方式获得SUVR的定量分析均可以鉴别AD与HC组、AD与MCI组,组间SUVR差异有统计学意义(F值:1.76~10.09,t值:2.98~7.47,均P<0.05),但HC与MCI组间SUVR差异无统计学意义(t值:0.17~1.53,均P>0.05)。ROC曲线分析示以下SUVR界值鉴别诊断较好:AD与HC组,全脑1.18(AUC=0.89)、杏仁核1.13(AUC=0.94)、海马旁回1.26(AUC=0.94);AD与MCI组,全脑1.06(AUC=0.82)、杏仁核1.18(AUC=0.88)、颞下回1.28(AUC=0.88)。全脑及额叶、枕叶、顶叶、颞叶、岛叶的SUVR与MMSE和MoCA评分呈负相关(r值:-0.64~-0.40,均P<0.05)。结论在^(18)F-PI-2620 PET脑显像中,SUVR定量分析可以辅助鉴别AD与HC、AD与MCI;全脑和五大脑叶的SUVR与MMSE和MoCA评分存在负相关。Objective To evaluate the values of^(18)F-PI-2620 PET/CT brain imaging with SUV ratio(SUVR)in the assessment of tau protein deposition in the brain of patients with different cognitive disorders and its correlation with cognition.Methods This was a cross-sectional study.From December 2019 to November 2022,a total of 67 subjects including 54 patients with Alzheimer′s disease(AD;21 males,33 females,age(68.6±7.8)years),7 patients with mild cognitive impairment(MCI;1 male,6 females,age(63.1±11.2)years)and 6 healthy controls(HC;4 males,2 females,age(69.0±5.8)years)were enrolled retrospectively in Renji Hospital.All participants were examined by^(18)F-PI-2620 PET/CT.SUVRs of brain regions were obtained,including frontal lobe,temporal lobe,occipital lobe,parietal lobe,insular lobe,whole brain,as well as 10 independent brain ROIs(amygdala,orbitofrontal cortex,cingulate gyrus,superior occipital gyrus,superior parietal gyrus,inferior angular gyrus,precuneus,inferior temporal gyrus,entorhinal cortex and parahippocampal gyrus),with inferior cerebellum cortex as the reference region.All participants were estimated by cognitive scales(mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)).One-way analysis of variance and the least significant difference t test were used to compare the differences of SUVR in each brain region among HC,MCI and AD groups.ROC curve analysis was used to determine the optimal cut-off values of SUVR in each brain region for the differential diagnosis of AD-MCI and AD-HC.Pearson correlation analysis was employed to examine the correlations of SUVR with cognitive scale scores.Results The SUVR of whole brain was 1.40±0.31 in AD group,1.08±0.19 in MCI group,and 1.01±0.12 in HC group.SUVR analysis in the whole brain and each brain region could distinguish AD from HC,AD from MCI(F values:1.76-10.09,t values:2.98-7.47,all P<0.05),but could not distinguish HC from MCI(t values:0.17-1.53,all P>0.05).ROC curve analysis showed that the best cut-off value of SUVR was 1.18 for whole b

关 键 词：阿尔茨海默病 认知功能障碍 TAU蛋白质类 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]