^(18)F-FDG PET在记忆障碍患者中诊断阿尔茨海默病的效能  

Diagnostic efficiency of ^(18)F-FDG PET for Alzheimer′s disease in patients with memory impairment

作　　者：张焱 张晨鹏[1] 黄干 王成[1] 辛玫[1] 邵泓达 王悦[1] 万良荣[1] 邱菊 徐群[2] 李霞[3] 刘建军[1] Zhang Yan;Zhang Chenpeng;Huang Gan;Wang Cheng;Xin Mei;Shao Hongda;Wang Yue;Wan Liangrong;Qiu Ju;Xu Qun;Li Xia;Liu Jianjun(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,Alzheimer′s Disease and Related Disorders Center,Shanghai Jiao Tong University,Shanghai 200030,China)

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12期712-717,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家重点研发计划(2023YFC3603200)。

摘　　要：目的研究^(18)F-FDG PET显像诊断记忆障碍患者中阿尔茨海默病(AD)的效能。方法回顾性收集2019年8月至2023年9月上海交通大学医学院附属仁济医院96例初始诊断为记忆障碍的患者[男40例、女56例,年龄69.0(62.8,74.0)岁]。以^(18)F-AV45+^(18)F-PI-2620 PET/CT+MRI显像结果为AD诊断的淀粉样蛋白、tau、神经变性(ATN)标准,应用视觉评估[颞、顶叶均代谢减低或后扣带回(PCC)代谢减低]和软件半定量分析[PET-SCORE和NeuroQ软件SUV比值(SUVR)]评价^(18)F-FDG PET显像在AD患者中的诊断效能。用χ^(2)检验比较视觉评估和半定量参数的诊断效能,并对PET-SCORE与认知量表评分进行Pearson相关分析。结果96例患者中,最终临床诊断为AD 61例,非AD 35例。^(18)F-FDG PET显像颞、顶叶视觉评估的诊断灵敏度最高[91.80%(56/61)],与PET-SCORE[40.98%(25/61);χ^(2)=29.03,P<0.001]、PCC视觉评估[77.05%(47/61);χ^(2)=5.82,P=0.016]差异有统计学意义;而PET-SCORE的诊断特异性最高[100%(35/35)],与视觉评估的特异性[颞、顶叶均代谢减低:17.14%(6/35),χ^(2)=27.03,P<0.001;PCC代谢减低:54.29%(19/35),χ^(2)=14.06,P<0.001]差异有统计学意义。PET-SCORE与患者简易精神状态检查量表(MMSE)、蒙特利尔认知评价量表(MoCA)、日常生活活动能力量表(ADL)评分之间存在相关性(r值:-0.38、-0.36、0.31,均P<0.01)。结论在初始诊断为记忆障碍的患者中,^(18)F-FDG PET图像视觉评估具有较高的AD诊断灵敏度,半定量分析PET-SCORE具有较高的特异性。PET-SCORE与反映患者认知下降严重程度的量表评分相关。ObjectiveTo assess the diagnostic efficiency of ^(18)F-FDG PET for Alzheimer′s disease(AD)in patients with memory impairment.MethodsA retrospective analysis was conducted on 96 patients(40 males,56 females,age:69.0(62.8,74.0)years)initially diagnosed with memory impairment in Renji Hospital,School of Medicine,Shanghai Jiao Tong University between August 2019 and September 2023.The amyloid-tau-neurodegeneration(ATN)criteria,based on ^(18)F-AV45+^(18)F-PI-2620 PET/CT+MRI imaging results,were used as the diagnostic standard for AD.Visual analysis(temporoparietal or posterior cingulate cortex(PCC)hypometabolism)and semi-quantitative analysis methods(PET-SCORE and NeuroQ software analysis(SUV ratio,SUVR))were applied to evaluate the diagnostic efficiency of ^(18)F-FDG PET imaging for AD.Diagnostic efficiencies of visual assessment and semi-quantitative parameters were compared byχ^(2) test.Additionally,Pearson correlation analysis was performed to examine the relationship between results of PET-SCORE and cognitive scales.ResultsOf the 96 patients initially diagnosed with memory impairment,61 were clinically diagnosed with AD,while 35 were non-AD patients.Visual assessment of temporoparietal hypometabolism showed the highest sensitivity(91.80%,56/61),which was significantly different from the sensitivities of PET-SCORE(40.98%(25/61);χ^(2)=29.03,P<0.001)and visual assessment of PCC hypometabolism(77.05%(47/61);χ^(2)=5.82,P=0.016).While semi-quantitative assessment using PET-SCORE demonstrated the highest specificity(100%,35/35),which was significantly different from the specificities of visual assessment methods(temporoparietal hypometabolism:17.14%(6/35),χ^(2)=27.03,P<0.001;PCC hypometabolism:54.29%(19/35),χ^(2)=14.06,P<0.001).PET-SCORE exhibited statistically significant correlations with Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),and Activities of Daily Living(ADL)scores(r values:-0.38,-0.36,0.31,all P<0.01).ConclusionsAmong patients initially diagnosed with memory impairment,visua

关 键 词：记忆障碍 阿尔茨海默病 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 乙二醇类 吡啶类 磁共振成像 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]