摘要
目的通过11C-2β-甲氧甲酰-3β-(4-氟苯基)托烷(CFT)和18F-脱氧葡萄糖(FDG) PET/CT脑显像研究震颤与非震颤帕金森病(PD)患者的代谢特点。方法纳入2018年3月至2019年3月的PD患者28例[震颤组19例:男14例、女5例,年龄(59.9±11.4)岁;非震颤组9例:男3例、女6例,年龄(62.6±9.0)岁]。采用感兴趣区(ROI)技术进行计算,比较2组患者尾状核、前壳核和后壳核11C-CFT摄取值及各脑区18F-FDG的摄取值。采用两样本t检验或Mann-Whitney u检验分析数据。结果震颤组PD患者的尾状核11C-CFT摄取值明显高于非震颤组(3.03±0.51与2.60±0.62;t=2.687, P<0.05),而非震颤组患者丘脑18F-FDG的摄取值明显高于震颤组(1.14±0.05与1.10±0.03;t=3.449, P<0.01)。以改良Hoehn-Yahr分级判定病情严重程度,震颤组患者在疾病进展期(分级≥2.5级)壳核和小脑葡萄糖代谢均较非震颤组进展期增高(1.27±0.04与1.21±0.05,0.94±0.04与0.86±0.08;t值:2.695和2.492,均P<0.05),震颤组进展期运动前区代谢较早期减低(1.07±0.02与1.10±0.03;t=2.053,P<0.05)。结论11C-CFT和18F-FDG PET/CT显像能较好地反映震颤与非震颤PD患者的不同代谢特征,有助于2种疾病亚型的临床诊疗和鉴别诊断。
Objective To investigate the metabolic patterns of 11C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl)tropane (CFT) and 18F-fluorodeoxyglucose (FDG) PET/CT imaging in patients with tremor and non-tremor Parkinson′s disease (PD). Methods From March 2018 to March 2019, 28 PD patients (19 tremor patients: 14 males and 5 females, age:(59.9±11.4) years;9 non-tremor patients: 3 males and 6 females, age:(62.6±9.0) years) were enrolled. For the two groups, the 11C-CFT uptake values in caudate nucleus, anterior putamen and posterior putamen as well as 18F-FDG uptake values in all brain regions were calculated by regions of interest (ROI) method. Two-sample t test or Mann-Whitney u test were used to analyze the data. Results Caudate nucleus 11C-CFT uptake in PD patients with tremor was higher than that without tremor (3.03±0.51 vs 2.60±0.62;t=2.687, P<0.05). Yet thalamus glucose uptake of non-tremor PD patients showed more active than tremor patients (1.14±0.05 vs 1.10±0.03;t=3.449, P<0.01). Sorted by modified Hoehn-Yahr stage, tremor patients in advanced stage (stage≥2.5) were characterized by glucose uptake increase in the putamen and cerebellum compared with non-tremor advanced group (1.27±0.04 vs 1.21±0.05, 0.94±0.04 vs 0.86±0.08;t values: 2.695 and 2.492, both P<0.05). Metabolic decrease in the premotor areas was observed in tremor patients in advanced stage compared with early stage (1.07±0.02 vs 1.10±0.03;t=2.053, P<0.05). Conclusion 11C-CFT and 18F-FDG PET/CT imaging can indicate different metabolic patterns between tremor and non-tremor PD, thus providing information for clinical practice and differential diagnosis.
作者
辛玫
张晨鹏
王成
万良荣
王智樱
管阳太
刘建军
黄钢
Xin Mei;Zhang Chenpeng;Wang Cheng;Wan Liangrong;Wang Zhiying;Guan Yangtai;Liu Jianjun;Huang Gang(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;Shanghai University of Medicine and Health Sciences, Shanghai 201318, China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2019年第6期344-348,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
上海申康医院发展中心临床创新三年行动计划(16CR2020A)
国家自然科学基金(81701725)
上海市"医苑新星"青年医学人才培养资助计划(沪卫人事[2012]105号).
