脑部PET扫描结合ACE-Ⅲ量表评估对MCI的诊断价值及MCI进展为AD型痴呆的预测价值研究

Research on the Diagnostic Value of Brain PET Scan Combined with ACE-Ⅲ Scale for Mild Cognitive Impairment and the Predictive Value of MCI Progression to AD Dementia

目的分析脑部PET扫描结合ACE-Ⅲ量表评估对轻度认知功能障碍(MCI)的诊断价值及对MCI进展为AD型痴呆的预测价值。方法选择昆山市第二人民医院2020年6月至2021年12月住院患者70例为研究对象,均给予脑部PET检查,以ACE-Ⅲ量表评估认知功能,将《2018中国痴呆与认知障碍诊治指南》作为诊断MCI的金标准,对比脑部PET、ACE-Ⅲ量表单独与联合诊断MCI的准确率、特异度、灵敏度,Kappa检验脑部PET、ACE-Ⅲ量表与金标准的一致性。将脑部PET确诊的52例患者作为观察组,选取同期体检中心体检的52例健康人员作为对照组,对比两组SUV值、RSUV值。绘制ROC曲线,分析PET扫描结合ACE-Ⅲ量表诊断MCI进展为AD型痴呆的特异度、灵敏度。结果脑部PET+ACE-Ⅲ量表诊断准确率(92.86%)、灵敏度(93.94%)、特异度(75.00%)均高于脑部PET(74.29%、77.27%、25.00%)、ACE-Ⅲ量表(78.57%、80.30%、50.00%)(P<0.05),脑部PET+ACE-Ⅲ量表与金标准的一致性较好,脑部PET、ACE-Ⅲ量表与金标准的一致性一般。观察组小脑、额叶、丘脑、基底节区、颞叶左侧、右侧SUV值均低于对照组(P<0.05)。观察组额叶、丘脑、基底节区、颞叶左侧、右侧RSUV值均高于对照组(P<0.05)。PET扫描结合ACE-Ⅲ量表预测MCI进展为AD型痴呆的特异度是61.8%、灵敏度是63.5%。结论脑部PET扫描结合ACE-Ⅲ量表可提高对MCI诊断的准确率、灵敏度、特异度,对MCI进展为AD型痴呆的预测价值较高。

Objective To analyze the diagnostic value of brain PET scan combined with ACE-III scale for MCI and the predictive value of MCI progression to AD dementia.Methods The subjects of this study were 70 patients hospitalized in Kunshan Second People's Hospital from June 2020 to December 2021.All of them were given brain PET examination,and the cognitive function was assessed by the ACE-III scale."Guide"as the gold standard for diagnosing MCI,comparing the accuracy,specificity,and sensitivity of brain PET and ACE-III scales alone and in combination to diagnose MCI,Kappa tests the consistency of brain PET and ACE-III scales with the gold standard.Fifty-two patients diagnosed by brain PET were selected as the observation group,and 52 healthy persons who underwent physical examination in the physical examination center during the same period were selected as the control group,and the SUV and RSUV values of the two groups were compared.ROC curve was drawn to analyze the specificity and sensitivity of PET scan combined with ACE-III scale in predicting MCI progression to AD dementia.Results The diagnostic accuracy(92.86%),sensitivity(93.94%),and specificity(75.00%)of brain PET+ACE-III scale were higher than those of brain PET(74.29%,77.27%,25.00%)and the amount of ACE-III.Table(78.57%,80.30%,50.00%)for diagnosis(P<0.05),brain PET+ACE-III scale was in good agreement with the gold standard,brain The consistency of the PET and ACE-III scales with the gold standard was general.The SUV values of the cerebellum,frontal lobe,thalamus,basal ganglia,left and right temporal lobe in the observation group were lower than those in the control group(P<0.05).The RSUV values of the frontal lobe,thalamus,basal ganglia,left and right temporal lobes in the observation group were higher than those in the control group(P<0.05).The specificity and sensitivity of PET scan combined with ACE-III scale to predict the progression of MCI to AD dementia were 61.8%and 63.5%.Conclusion Brain PET scan combined with ACE-III scale can improve the diagnostic accuracy,sensitivity and specificity of MCI,and has a high predictive value for the progression of MCI to AD dementia.