运用PET评估非症状性颈动脉狭窄支架植入前后脑葡萄糖代谢变化

Changes of cerebral glucose metabolism assessed by positron emission tomography before and after carotid artery stenting in asymptomatic carotid stenosis

目的 探讨非症状性颈动脉狭窄行颈动脉支架植入前后脑葡萄糖代谢率的变化.方法 依据相关标准,在南京卒中注册系统中筛选出自2010年3月至12月连续登记的11例接受颈动脉支架植入术的非症状性颈动脉狭窄患者.所有患者术前及术后3个月分别进行PET-CT检查（18F-FDG示踪）,采用感兴趣区法记录各动脉供血区脑葡萄糖的标准摄取最大值,并应用统计学方法比较术前术后患侧颈动脉区域脑代谢值及与对侧比较. 结果 术前患侧颈动脉区域脑葡萄糖标准摄取最大值平均值为（4.99±0.96）,明显低于对侧（5.67±1.27）,差异有统计学意义（P＜0.05）.随访时患侧颈动脉区域脑葡萄糖标准摄取最大值平均值为（5.83±l10）,较术前明显提高,差异有统计学意义（P＜0.05）,但与术后对侧（5.85±1.08）比较差异无统计学意义（P＞0.05）. 结论 非症状性颈动脉狭窄患侧脑葡萄糖代谢率显著降低,而行颈动脉支架植入术能明显改善患侧脑葡萄糖代谢率.

Objective To evaluate the changes of cerebral glucose metabolism before and after carotid artery stenting （CAS） in patients with asymptomatic carotid stenosis.Methods Eleven patients,admitted to and performed CAS in our hospital from March 2010 to December 2010,were enrolled.The patients received PET-CT examination before and 3 months after CAS （tracking by 18F-FDG）.The max standardized uptake value （SUVmax） of each artery supplement area was recorded by region of interest （ROI） method.The metabolism of affected carotid artery area was compared before and after CAS,and the affected carotid area and the unaffected one.Results The SUVmax before CAS in the affected carotid area （4.99±0.96） was significantly lower than that of the unaffected one （5.67±1.27,P〈0.05）; follow-up SUVmax in the affected carotid area （5.83 ±1.10） was significantly increased as compared with that before CAS （P〈0.05）; follow-up SUVmax in the affected carotid area showed no significant difference as compared with that in the unaffected one after CAS （5.85±1.08,P〉0.05）.Conclusion The cerebral glucose metabolism of the affected carotid area decreases significantly,which could be improved after CAS.